How To Use CPT Code 42227

CPT 42227 describes the lengthening of the soft palate using island flaps in the mucosal tissue. 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 42227?

CPT 42227 can be used to describe the surgical procedure in which the soft palate is lengthened by creating island flaps in the mucosal tissue and suturing them in new positions. This code is used when the provider makes incisions at the junction of the hard and soft palate to resurface the oral defect and harvests a palatal island flap to widen the palate without compromising the vascular pedicle.

2. Official Description

The official description of CPT code 42227 is: ‘Lengthening of palate, with island flap.’

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. Incisions are made at the junction of the hard and soft palate to resurface the oral defect.
3. A palatal island flap, consisting of nutrient vessels, is harvested.
4. The flap is rotated 180 degrees to widen the palate without compromising the vascular pedicle.
5. The donor site is allowed to heal by secondary intention.

4. Qualifying circumstances

CPT 42227 is performed on patients who require lengthening of the soft palate. This procedure is typically done to address issues such as velopharyngeal insufficiency or to correct a short palate. The patient must be appropriately prepped and anesthetized for the procedure.

5. When to use CPT code 42227

CPT code 42227 should be used when the provider performs the lengthening of the soft palate using island flaps in the mucosal tissue. It is important to note that this code should not be used for procedures involving pharyngeal flaps or cleft palate palatoplasty.

6. Documentation requirements

To support a claim for CPT 42227, the provider must document the following information:

• Patient’s diagnosis necessitating the lengthening of the soft palate
• Description of the procedure performed, including the use of island flaps
• Date of the procedure
• Details of the incisions made and the rotation of the palatal island flap
• Information about the healing process of the donor site
• Signature of the provider

7. Billing guidelines

When billing for CPT 42227, ensure that the procedure performed matches the description of the code. It is important to note that CPT 42227 should not be reported with other codes unless specifically indicated. For pharyngeal flap procedures, use CPT code 42226. For cleft palate palatoplasty, refer to the appropriate range of codes from 42200 to 42225.

8. Historical information

CPT 42227 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 provider performs CPT 42227 to lengthen the soft palate of a patient with velopharyngeal insufficiency.
2. During a surgical procedure, the provider uses CPT 42227 to correct a short palate in a patient.
3. A patient undergoes CPT 42227 to address speech issues caused by velopharyngeal insufficiency.
4. A provider performs CPT 42227 to improve the function of the soft palate in a patient with a history of cleft palate.
5. Using CPT 42227, a provider lengthens the soft palate of a patient to improve their ability to swallow and speak.
6. A patient with velopharyngeal insufficiency undergoes CPT 42227 to address their speech difficulties.
7. During a surgical procedure, the provider uses CPT 42227 to correct a short palate and improve the patient’s quality of life.
8. A provider performs CPT 42227 to address nasal regurgitation in a patient with velopharyngeal insufficiency.
9. Using CPT 42227, a provider lengthens the soft palate of a patient to improve their ability to produce certain speech sounds.
10. A patient with a history of cleft palate undergoes CPT 42227 to improve the function of their soft palate.