How To Use CPT Code 42420

CPT 42420 describes the excision of a parotid gland with a tumor, including dissection and preservation of the facial nerve. 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 42420?

CPT 42420 is used to describe the surgical removal of a parotid gland with a tumor, while also performing dissection and preservation of the facial nerve. This code is used when the provider makes an incision in front of the ear, extends it to the neck, and carefully removes the parotid gland while ensuring the integrity of the facial nerve is maintained.

2. Official Description

The official description of CPT code 42420 is: ‘Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve.’

3. Procedure

1. The provider prepares the patient for the procedure and administers anesthesia.
2. A curvilinear incision is made in front of the ear, extending it to the neck towards the mid jaw bone.
3. The tissue is dissected, and an electrical nerve stimulation device is used to locate and preserve the facial nerve during the procedure.
4. The lateral lobe of the parotid gland is dissected from the nerve branches, and the nerve is moved to protect it during the removal of the rest of the gland.
5. The incision is closed in layers to complete the procedure.

4. Qualifying circumstances

CPT 42420 is performed on patients who require the removal of a parotid gland with a tumor, while also preserving the facial nerve. The procedure is typically performed by a qualified healthcare provider who has the necessary expertise in parotid gland surgery and facial nerve preservation.

5. When to use CPT code 42420

CPT code 42420 should be used when a provider performs a total excision of a parotid gland with a tumor, while also performing dissection and preservation of the facial nerve. This code is appropriate when the entire parotid gland needs to be removed, and the provider takes extra care to protect the facial nerve during the procedure.

6. Documentation requirements

To support a claim for CPT 42420, the provider must document the following information:

• Patient’s diagnosis and the need for parotid gland excision
• Details of the surgical procedure, including the incision site and technique used
• Documentation of the dissection and preservation of the facial nerve
• Any complications or additional procedures performed during the surgery
• Post-operative care instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 42420, ensure that the procedure meets the criteria for total excision of the parotid gland with dissection and preservation of the facial nerve. It is important to accurately document the details of the procedure and any additional services provided. Review the documentation and compare it to the official description of CPT 42420 to ensure accurate coding. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 42420 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A surgeon performs a total excision of a parotid gland with a tumor, while also preserving the facial nerve, in a patient with a diagnosed parotid tumor.
2. A patient undergoes a surgical procedure in which the provider removes the entire parotid gland, including dissection and preservation of the facial nerve, to treat a malignant tumor.
3. A qualified healthcare professional performs a total excision of a parotid gland with a tumor, ensuring the integrity of the facial nerve, in a patient with a recurrent parotid tumor.
4. A surgeon performs a total excision of a parotid gland with a tumor, while also preserving the facial nerve, in a patient with a benign parotid tumor.
5. A provider performs a total excision of a parotid gland with a tumor, taking extra care to dissect and preserve the facial nerve, in a patient with a suspected parotid malignancy.
6. A patient undergoes a surgical procedure in which the provider removes the entire parotid gland, including dissection and preservation of the facial nerve, to alleviate symptoms caused by a parotid tumor.
7. A qualified healthcare professional performs a total excision of a parotid gland with a tumor, ensuring the integrity of the facial nerve, in a patient with a recurrent parotid tumor.
8. A surgeon performs a total excision of a parotid gland with a tumor, while also preserving the facial nerve, in a patient with a benign parotid tumor.
9. A provider performs a total excision of a parotid gland with a tumor, taking extra care to dissect and preserve the facial nerve, in a patient with a suspected parotid malignancy.
10. A patient undergoes a surgical procedure in which the provider removes the entire parotid gland, including dissection and preservation of the facial nerve, to alleviate symptoms caused by a parotid tumor.