CPT for ENT: Eagle’s Syndrome

Q: How do I code for Eagle’s Syndrome and its treatment?

A: Eagle’s syndrome is a condition caused by an elongated styloid process or calcified stylohyoid ligament. Symptoms may include dull pain of the throat, neck and face, dysphagia, and foreign body sensation of the throat. Treatment of this syndrome is usually done by surgically shortening the styloid process (typically transorally) and/or addressing the calcified ligament, if needed, (typically with a cervical approach).

As there is no specific ICD-9 code for the syndrome, it is best to code for symptoms presented by the patient. They are typically facial pain (784.0), throat pain (784.1), neck pain (723.1) and dysphasia (784.5). Other options may include other disorders of muscle, ligament and fascia (728.89).

Suggested crosswalk to ICD-10 codes:

• 784.0–> G50.1 (atypical facial pain)
• 784.1–> R07.0 (Pain in throat)
• 723.1–> M54.2 (Cervicalgia)
• 784.5–> R13.19 (Other dysphagia)
• 728.89–> M62.89 (Other specified disorders of muscle)

Another potential option is M89.8X8 (Other specific disorders of Bone, unspecified site).

When coding for shortening of the styloid process use CPT code 21499 Unlisted musculoskeletal procedure, head. Make sure your operative note clearly details the procedure performed.

Reviewed October 2023

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CPT FOR ENT ARTICLES ARE A COLLABORATIVE EFFORT BETWEEN THE ACADEMY’S TEAM OF CPT ADVISORS, MEMBERS OF THE PHYSICIAN PAYMENT POLICY (3P) WORKGROUP, AND HEALTH POLICY STAFF. ARTICLES ARE DEVELOPED TO ADDRESS COMMON CODING QUESTIONS RECEIVED BY THE HEALTH POLICY TEAM, AS WELL AS TO CLARIFY CODING CHANGES AND CORRECT CODING PRINCIPLES FOR FREQUENTLY REPORTED ENT PROCEDURES. THESE ARTICLES ARE NOT INTENDED AS LEGAL, MEDICAL, OR BUSINESS ADVICE AND ARE NOT A GUARANTEE OF REIMBURSEMENT. THE INFORMATION IS ALSO NOT MEANT TO SERVE AS THE DEFINITIVE OR SOLE AUTHORITY ON BILLING AND CODING ISSUES. THE APPLICABILITY OF AAO-HNS BILLING AND CODING GUIDANCE FOR A PARTICULAR PROCEDURE, MUST BE DETERMINED BY THE RESPONSIBLE PHYSICIAN IN LIGHT OF ALL THE CIRCUMSTANCES PRESENTED BY THE INDIVIDUAL PATIENT. YOU SHOULD CONSULT WITH YOUR OWN ADVISORS AS WELL AS MEDICARE OR PRIVATE CARRIERS IN MAKING ANY DECISIONS ABOUT HOW TO BILL AND CODE PARTICULAR SERVICES OR PROCEDURES.