How To Use CPT Code 42107

CPT 42107 describes the excision of a lesion on the palate or uvula, followed by closure using a local flap. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 42107?

CPT 42107 is used to describe the excision of a lesion on the palate or uvula, with closure using a local flap. This code is used when a healthcare provider removes a damaged or diseased tissue from the roof of the mouth or the fleshy body that hangs from the soft palate at the back of the mouth. The procedure involves making an elliptical-shaped incision, removing the lesion along with a small margin of surrounding tissue, and closing the site using a flap from adjacent tissues.

2. Official Description

The official description of CPT code 42107 is: ‘Excision, lesion of palate, uvula; with local flap closure.’

3. Procedure

1. The healthcare provider preps and anesthetizes the patient.
2. An elliptical-shaped incision is made at the target site in the palate or uvula.
3. The provider removes the lesion along with a small margin of surrounding tissue.
4. The removed tissue may be sent to pathology for further analysis.
5. The site is flushed with sterile saline and antibiotics are applied.
6. A flap from adjacent tissues is used to close the site, helping to restore blood supply to the area.

4. Qualifying circumstances

CPT 42107 is performed on patients with lesions on the palate or uvula that require excision and closure using a local flap. The procedure is typically done to remove damaged or diseased tissue. It is important to note that this code is specifically for excision with local flap closure and should not be used for skin grafts or mucosal grafts.

5. When to use CPT code 42107

CPT code 42107 should be used when a healthcare provider performs an excision of a lesion on the palate or uvula and closes the site using a local flap. It is important to review other codes in the range (42100-42160) to ensure the most appropriate code is chosen for the specific case.

6. Documentation requirements

To support a claim for CPT code 42107, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for excision of the lesion
• Details of the procedure, including the incision, removal of the lesion, and closure using a local flap
• Any additional procedures performed, such as sending the removed tissue for pathology analysis
• Use of sterile saline and antibiotics
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 42107, ensure that the excision and closure using a local flap are performed by a qualified healthcare provider. It is important to follow the specific guidelines for reporting this code and to review other codes in the range to ensure accurate coding. Additionally, it is important to consider any applicable modifiers or additional procedures performed during the same encounter.

8. Historical information

CPT code 42107 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider performs an excision of a lesion on the palate and closes the site using a local flap.
2. A patient presents with a lesion on the uvula, and a healthcare provider performs an excision and closure using a local flap.
3. A healthcare provider removes a damaged tissue from the palate and closes the site using a local flap.
4. An individual undergoes an excision of a lesion on the uvula, and the site is closed using a local flap.
5. A healthcare provider performs an excision of a lesion on the palate and uses a local flap for closure.
6. A patient with a lesion on the uvula undergoes an excision and closure using a local flap.
7. A healthcare provider removes a diseased tissue from the palate and closes the site using a local flap.
8. An individual undergoes an excision of a lesion on the uvula, and the site is closed using a local flap.
9. A healthcare provider performs an excision of a lesion on the palate and uses a local flap for closure.
10. A patient with a lesion on the uvula undergoes an excision and closure using a local flap.