Procedure Type: Adenotonsillectomy

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Description

This phenotype determines whether the case includes Tonsilectomy, Adenoidectomy, Adenotonsillectomy or control of postop tonsil bleed using logic based upon a combination of surgical CPT codes and procedure text.

Limitation

May include cancelled cases. This phenotype may incorrectly result cases that are scheduled as tonsillectomy, possible adenoidectomy and vice versa.

Relies on accurate procedure text documentation, anesthesia, and surgical CPT codes.

Data quality is limited to individual site documentation accuracy, completeness, and variable mapping, which is performed by each site, independently. MPOG, as the coordinating center, reviews data quality at each data upload and monthly via Data Diagnostics and Case Validation tools. This review, while thorough, may not contain all data elements relevant to this phenotype and thus should be carefully reviewed by the user.

Value Type

Categorical

Enumeration

Value	Value Code	Definition

Return Columns

Column Name	Data Type

Granularity

Logic

The following checks are processed in order. Once a check is true, that value is assigned and no further checks are applied.

Does procedure text include "Bleed" , "Coag" , "Control" AND was an Emergent procedure? If yes, assign Tonsil Bleed and stop. If no, proceed
Does procedure text include "Tons" AND "Adenoid" OR "Adenotons", "T&A", "T/A" OR matches on surgical CPT codes 42820 or 42821? If yes, assign Adenotonsillectomy and stop. If no, proceed
Does procedure text include "Tons" and not ‘"Adenoid" and not "Adenotons" and not CPT code 42820 or 42821? If yes, assign Tonsillectomy and stop. If no, proceed
Does procedure text include ‘adenoid’ and not ‘tons’ and not CPT codes 42820 or 42821? If yes, assign Adenoidectomy and stop. If no, proceed
Does procedure text include ‘tons’ and not ‘adenoid’ and not ‘adenotons’? If yes, assign Tonsillectomy and stop. If no, proceed
Does procedure text include ‘adenoid’ and not ‘tons’? If yes, assign Adenoidectomy and stop. If no, proceed
Does case have Tonsil CPT codes (42825, 42826, 42842, 42844, 42845, 42870, 42961, 42962)? If yes, assign Tonsillectomy and stop. If no, proceed
Does case have Adenoid CPT codes (42830, 42831, 42835, 42836)? If yes, assign Adenoidectomy and stop. if no, return No.

Surgical CPT Code	Description
42820	Tonsillectomy and adenoidectomy; younger than age 12
42821	Tonsillectomy and adenoidectomy; age 12 or over
42825	Tonsillectomy, primary or secondary; younger than age 12
42826	Tonsillectomy, primary or secondary; age 12 or over
42842	Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure
42844	Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with local flap
42845	Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap
42830	Adenoidectomy, primary; younger than age 12
42831	Adenoidectomy, primary; age 12 or over
42835	Adenoidectomy, secondary; younger than age 12
42836	Adenoidectomy, secondary; age 12 or over
42870	Excision or destruction lingual tonsil, any method (separate procedure)
42961	Control oropharyngeal hemorrhage, primary or secondary; complicated, requiring hospitalization
42962	Control oropharyngeal hemorrhage, primary or secondary; with secondary surgical intervention

Procedure Text Keywords

Tonsil

"Tons"

Adenoid

"Adenoid"

Adenotonsillectomy

"Adenotons"
"T&A"
"T/A"

Tonsil Bleed

"Bleed"
"Coag"
"Control"