How To Use CPT Code 42425

CPT 42425 describes the excision of the parotid gland or parotid tumor with the sacrifice 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 42425?

CPT 42425 is used to describe the surgical removal of the parotid gland or parotid tumor, where the facial nerve is sacrificed. This procedure involves making an incision in front of the ear to the neck and towards the mid jawbone. The provider then removes the entire parotid gland or tumor, keeping it within the surrounding capsule. The incision is closed with sutures.

2. Official Description

The official description of CPT code 42425 is: ‘Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve.’

3. Procedure

1. The provider makes a curvilinear incision in front of the ear to the neck and towards the mid jawbone.
2. They access the parotid gland or parotid neoplastic growth.
3. The entire parotid gland or tumor is removed off the normal tissues using en bloc removal, where the tissue remains within the capsule surrounding it.
4. The procedure requires the sacrifice of the facial nerve.
5. The incision is closed in layers with sutures.

4. Qualifying circumstances

CPT 42425 is performed when the parotid gland or parotid tumor needs to be completely removed, and sacrificing the facial nerve is necessary. This procedure is typically done when the tumor is malignant or when there is a significant risk of malignancy. It is important to note that this procedure should only be performed by a qualified healthcare professional with the appropriate training and expertise.

5. When to use CPT code 42425

CPT code 42425 should be used when the provider performs a total, en bloc removal of the parotid gland or parotid tumor with the sacrifice of the facial nerve. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 42425, the provider must document the following information:

• Patient’s diagnosis and the need for the excision of the parotid gland or tumor
• Details of the procedure, including the incision site and the extent of the removal
• Confirmation of the sacrifice of the facial nerve
• Any additional procedures performed during the same surgical session
• Post-operative care instructions and follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 42425, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the procedure and any additional services provided. Review the documentation thoroughly to ensure accurate coding and billing. It is also important to follow any specific billing guidelines provided by the payer or regulatory authorities.

8. Historical information

CPT 42425 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 patient undergoes excision of a parotid tumor with the sacrifice of the facial nerve to ensure complete removal.
2. A provider performs en bloc removal of the parotid gland with the sacrifice of the facial nerve due to the presence of a malignant tumor.
3. A surgical team performs total removal of the parotid gland with the sacrifice of the facial nerve to address a large parotid tumor.
4. A patient undergoes excision of the parotid gland with the sacrifice of the facial nerve to prevent the spread of a malignant tumor.
5. A provider performs en bloc removal of a parotid tumor with the sacrifice of the facial nerve to ensure complete eradication of the tumor.
6. A surgical procedure involves the total removal of the parotid gland with the sacrifice of the facial nerve to address a complex parotid tumor.
7. A patient undergoes excision of the parotid gland with the sacrifice of the facial nerve to treat a recurrent parotid tumor.
8. A provider performs en bloc removal of a parotid tumor with the sacrifice of the facial nerve to prevent the spread of cancerous cells.
9. A surgical team performs total removal of the parotid gland with the sacrifice of the facial nerve to address a large and invasive parotid tumor.
10. A patient undergoes excision of the parotid gland with the sacrifice of the facial nerve to eliminate the risk of tumor recurrence.