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Table 6 Top Procedure Codes by Subspecialty

From: Consultation diagnoses and procedures billed among recent graduates practicing general otolaryngology – head & neck surgery in Ontario, Canada

Rank Code General (39.2%) % Code Otology (23.5%) %
1 Z296 Fiberoptic endoscopy of upper airway with flexible endoscope 82 G420 Ear syringing, curetting or debridement 54
2 Z299 Fiberoptic endoscopy of upper airway with rigid endoscope 2 Z907 Debridement under microscopy, debridement of mastoid cavities, and/or ears with significant external or middle ear pathology but not for removal of cerumen - unilateral 37
3 Z118 Aspiration of superficial lump for cytology 2 E336 Tympanoplasty-type one 1
4 Z915 Removal foreign body (simple) 1 E323 Myringoplasty 1
5 Z501 Mouth Incisional Biopsy 1 E301 Resection of pinna - with local flap < 1
6 Z326 Change of tracheostomy tube 1 E300 Resection of pinna - with primary closure < 1
7 Z515 Oesophagoscopy, with or without biopsy(ies) 1 Z908 Debridement under microscopy, debridement of mastoid cavities, and/or ears with significant external or middle ear pathology but not for removal of cerumen - unilateral; General Anesthetic < 1
8 Z413 Scalene node fine needle aspiration 1 Z904 Local Excision of Polyp of external ear (office) < 1
9 Z327 Flexible or rigid bronchoscopy, with or without bronchial biopsy or suction < 1 Z866 Removal of Ear Foreign Body (complicated) under general anesthetic < 1
10 Z116 Skin Incisional Biopsy < 1 Z916 Intratympanic Injection < 1
Rank Code Head Neck (9.0%) % Code Endocrine (4.7%) %
1 R915 Comprehensive dissection of neck lymph nodes, must include 3 or more levels - unilateral 43 S788 Total Thyroidectomy 33
2 Z502 Excision Mouth Lesion - less than 2 cm. 6 S789 Subtotal Thyroidectomy 25
3 Z355 Quadroscopy or panendoscopy 3 Z771 Aspiration biopsy, thyroid gland/nodule fine needle method 18
4 R048 Simple Excision of Face or Neck Lesion - single 3 S795 Exploration and/or removal, parathyroids or parathyroid tumour 6
5 R910 Limited neck dissection, must include 2 levels (unilateral) or central compartment 3 E880 Parathyroid Reimplantation 3
6 M106 Excision of Mediastinal Tumor 3 S793 Completion Thyroidectomy 3
7 S043 Total Parotidectomy with facial nerve preservation 2 S790 Hemi-thryoidectomy 2
8 S003 Excision Mouth Lesion - 2 - 4 cm. 2 S061 Thyroglossal Duct Remnant Excision 2
9 E540 Skin Malignant Lesion wide excision in any area and must include > 1 cm margins and layered closure - performed in hospital with frozen section 2 S792 Re-exploration of neck for hyperparathyroidism < 1
10 Z119 Cryotherapy treatment of multiple pre-malig actinic keratosis 1 S787 Excisional Surgical Biopsy of the Thyroid Gland < 1
Rank Code Rhinology (9.3%) % Code General- (T&A M&T) (6.3%) %
1 Z302 Turbinate Reduction 13 Z914 Myringotomy with insertion of ventilation tube 57
2 M083 E844 Intranasal ethmoidectomy incl maxillary antrostomy with endoscope 11 S063 Tonsillectomy 29
3 Z314 Chemical/electrocautery for epistaxis 10 Z912 Myringotomy 8
4 Z305 Nasal polypectomy - general anesthesia 10 S065 Adenoidectomy 7
5 M012 Septoplasty 8    
6 M054 Intranasal maxillary antrostomy – unilateral – by endoscopic or endonasal approach. 6
7 Z315 Epistaxis - anterior packing 4
8 Z318 Trephine or endoscopic frontal sinusotomy 4
9 Z311 Removal of nasal foreign body (simple) 3
10 M060 Ethmoidectomy-intranasal-unilateral 2
Rank Code Facial Plastics (6.4%) % Code Laryngology (1.1%) %
1 R046 Rotations, Transpositions, Z-plasties of the face, neck, or scalp defect 2.1 cm to 5 cm 10 Z321 Direct Laryngoscopy-with or without biopsy 37
2 F136 Nasal Bones Closed Reduction 6 E600 Laryngoscopy using operative microscope 20
3 R045 Rotations, Transpositions, Z-plasties of the face, neck, or scalp defect less than 2 cm 5 Z323 Direct Laryngoscopy-with removal lesions 19
4 R011 Advancement flaps of the face, neck, scalp defect 2.1 cm to 5 cm 4 E643 Direct Laryngoscopy when using laser with microlaryngoscopy for benign disease 4
5 Z122 Excision of cyst, hemangioma, lipoma of face or neck 3 Z320 Insertion of voice prosthesis 4
6 R022 Scar revision of face or neck defect 2.6 cm–5 cm. 3 Z346 Transtracheal aspiration 2
7 R087 Split thickness graft - major - complex area 2 M090 Laryngoplasty 2
8 E551 Bone, fascial or dermal grafts - autogenous - separate incision 2 M080 Teflon augmentation larynx 2
9 G396 Injection of extensive keloids 2 G873 Botulinum toxin injection(s) for spasmodic dysphonia 1
10 R012 Advancement flaps of the face, neck, scalp defect 5.1 cm to 10 cm 2 M085 Arytenoidectomy or arytenoidopexy or lateralization procedure 1
Code Pediatrics (0.4%) %
E622 Any bronchoscopic procedure for patient under 3 years of age 79
R043 Removal of congenital dermoid cyst in an infant or child 3
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Journal of Otolaryngology - Head & Neck Surgery

ISSN: 1916-0216

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