Radiofrequência do palato

"Um doente com roncopatia faz, em cirurgia do ambulatório, tratamentos de radiofrequência (RF) do palato mole em várias sessões.
 À semelhança de RF dos cornetos devo utilizar destruction? 
 Ou deve ser repair? Neste caso parece-me mais lógico."

(Responde Fernando Lopes)
 
 
A radiofrequência é utilizada para provocar ablação.
O índice alfabético aponta a classificação do procedimento de ablação para a root operation Destruction:
 
Ablation see Destruction
O Coding Clinic tem vários exemplos de ablação por radiofrequência codificados como destruição.
Um caso, ainda da ICD-9-CM, refere-se a um tratamento dirigido para a apneia obstrutiva do sono em que, entre outros procedimentos, se faz radiofrequência do palato (ver a seguir).
O enquadramento na root operation Repair não seria correto dada a sua própria definição:
Explanation: Used only when the method to accomplish the repair is not one of the other root operations

 
A classificação deste procedimento é mesmo como destruição.
0C53XZZ Destruction of Soft Palate, External Approach
 
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Somnoplasty using radiofrequency energy 
Coding Clinic, Second Quarter 2002 Page: 5 to 6 
 
Question:
What is the code assignment for tongue-based somnoplasty performed with uvulopalatal pharyngoplasty, tonsillectomy, nasal septoplasty, and inferior turbinate diathermy for obstructive sleep apnea?  We are particularly interested in the correct code assignment for the somnoplasty portion of the surgery where radiofrequency energy is applied to the tongue.
 
Answer:
Assign code 25.1, Excision or destruction of lesion or tissue of tongue, for the somnoplasty.
 
Somnoplasty (temperature-controlled radiofrequency- based technology) is a new technique that is now being used to treat obstructive sleep apnea.  The procedure is performed under local anesthesia and treats obstructive sleep apnea by shrinking soft tissue in the upper airway such as the tonsils, nasal passages, palate and base of the tongue.  During the procedure, the area of tissue obstruction is heated just below the mucosal surface.  The body naturally absorbs the heated area after three to eight weeks.
 
The procedure can be performed under local anesthesia and is minimally invasive.  The system includes an automated radiofrequency (RF) control unit with temperature monitoring capabilities and a suite of single-use disposable surgical handpieces that deliver controlled thermal energy into targeted areas. Typically, the procedure for obstructive sleep apnea takes 30 to 45 minutes, with only five to 10 minutes required for RF energy delivery. The procedure can be performed on an outpatient basis. Multiple treatments may be required in order to obtain the best outcome.
 
Copyright 1984-2007, American Hospital Association ("AHA"), Chicago, Illinois.  Reproduced with permission. No portion of this publication may be copied without the express, written consent of AHA.
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