Clinical Indicators Compendium

Allergy
Allergy Testing for Allergic Rhinitis

Auditory System
Acoustic Neuroma Surgery
Auditory Brainstem
Mastoidectomy
Myringotomy/Tympanostomy Tubes
Stapedectomy/Stapedotomy
Tympanoplasty

Digestive System
Adenoidectomy
Parotidectomy
Tonsil/Adenoid/Adenotonsillectomy
Uvulopalatopharyngoplasty

Endocrine System
Thyroidectomy

Lymphatic System
Neck Dissection

Musculoskeletal System
LeFort Fracture
Mandibular Fracture
Nasal Septal Fracture

Respiratory System
Caldwell-Luc
Diagnostic Nasal Endoscopy
Endoscopic Debridement
Endoscopic Sinus Surgery, Adult
Endoscopic Sinus Surgery, Pediatric
Ethmoidectomy
Inferior Turbinate Surgery
Laryngoscopy/Nasopharyngoscopy
Laryngectomy
Rhinoplasty
Septoplasty
Tracheostomy

Therapeutic
Canalith Repositioning

Introduction

Clinical Indicators for Otolaryngology—Head and Neck Surgery were first developed in 1988 by the American Academy of Otolaryngology—Head and Neck Surgery's Quality Improvement (QI) Committee. Continual improvement in these clinical indicators is an ongoing project for our QI Committee.

There are several changes and additions in this edition. A logical argument is emphasized to justify the diagnosis. This places greater importance on the quality of the history, physical examination, and diagnostic tests. The justification (argument) is restricted to specific procedures and diagnoses described in the 2000 AMA CPT (Clinical Procedural Terminology) and ICD-9 (International Classification of Disease) code books. Also included are procedure-specific postoperative observations and outcome issues suggested for use by institutions and surgeons. Finally, there is a "Patient Information" section that may be shared with patients during surgical counseling.

In response to user comments, this document will be reevaluated and expanded annually. Concurrently, the QI Committee intends to develop practice guidelines that are more comprehensive and include documentation of opinions from the current literature.

Clinical indicators for otolaryngology serve as a checklist for practitioners and a quality care review tool for clinical departments. Because they are suggestions, not rules, they should be modified by users and the Academy when opportunities for improvement are discovered.

Patient Safety/Quality Improvement Committee

Michael G. Glenn, MD (Chair)
Ronald B. Kuppersmith, MD MBA (BOD Liaison) 
Ronald B. Kuppersmith, MD MBA (Consultant)
Sanford M. Archer, MD (Consultant)
Mark F. Williams, MD (Consultant)
Elizabeth Wilson Hoy, MHA   (Staff Liaison)
Evan S. Bates, MD
Alan D. Bruns, MD
Adriane P. Concus, MD
Etai Funk, MD
Matthew Allen Kienstra, MD
Jodi M. Kornak, MD
Brian J. McCool, MD
Jordan B. Pritikin, MD
David W. Roberson, MD
Richard M. Rosenfeld, MD, MPH
Gary T. Turner, MD
J. Nicholas Vandemoer, MD 
John W. Werning, MD, DMD
S.Thomas Westerman, MD, PA

Important Notice

The Clinical Indicators for Otolaryngology--Head and Neck Surgery are guidelines only. As medical knowledge expands and technology advances, clinical indicators and referral guidelines are promoted as conditional and provisional proposals of what is allowable, but not absolute. Referral guidelines and clinical indicators are not mandates and should never be interpreted as the standard of care.

The responsible physician, in light of all the circumstances presented by the individual patient, must determine the appropriate treatment. Adherence to these guidelines will not ensure successful patient outcomes in every situation. Adherence to these guidelines will not ensure successful patient outcomes in every situation.

The American Academy of Otolaryngology-Head and Neck Surgery, Inc. emphasizes that these clinical indicators should not be deemed inclusive of all proper treatment decisions or methods of care, nor exclusive of other treatment decisions or methods of care reasonably directed to obtaining the same results.

CPT five-digit codes, nomenclature, and other data are ©2000 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restsrictions apply to government use.