How To Use CPT Code 42720

CPT 42720 describes the procedure for incision and drainage of a retropharyngeal or parapharyngeal abscess using an intraoral approach. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 42720?

CPT 42720 is used to describe the incision and drainage of a retropharyngeal or parapharyngeal abscess. The procedure involves making an incision through the mouth to access and drain the abscess located in the throat or deep in the neck. This code is specifically used for an intraoral approach to the abscess.

2. Official Description

The official description of CPT code 42720 is: ‘Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes a horizontal incision into the retropharyngeal or parapharyngeal abscess using a surgical blade.
3. Additional tools may be used to help open and drain the abscess.
4. The provider applies antibiotics and may perform packing or closure if necessary.

4. Qualifying circumstances

CPT 42720 is performed when there is a retropharyngeal or parapharyngeal abscess that requires incision and drainage. These abscesses are sacs or pockets filled with pus in the soft tissue of the throat or deep in the neck. The procedure is performed using an intraoral approach, which means accessing the abscess through the mouth.

5. When to use CPT code 42720

CPT code 42720 should be used when the provider performs an incision and drainage procedure on a retropharyngeal or parapharyngeal abscess using an intraoral approach. It is important to note that if the procedure is performed via an external approach, CPT code 42725 should be used instead.

6. Documentation requirements

To support a claim for CPT 42720, the provider must document the following information:

• Patient’s diagnosis and the need for incision and drainage of the abscess
• Details of the procedure, including the use of an intraoral approach
• Date and time of the procedure
• Any additional treatments or interventions performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 42720, ensure that the procedure is performed using an intraoral approach. If the procedure is performed via an external approach, CPT code 42725 should be used instead. It is important to follow the specific guidelines provided by the payer regarding documentation and coding for this procedure.

8. Historical information

CPT code 42720 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 provider performs an incision and drainage procedure on a retropharyngeal abscess using an intraoral approach.
2. A patient presents with a parapharyngeal abscess, and the provider performs an incision and drainage procedure through the mouth.
3. A retropharyngeal abscess is identified in a child, and the provider performs an incision and drainage procedure using an intraoral approach.
4. A patient with a parapharyngeal abscess undergoes an incision and drainage procedure via an intraoral approach.
5. A provider performs an incision and drainage procedure on a retropharyngeal abscess in a patient using an intraoral approach.
6. An intraoral approach is used by a provider to perform an incision and drainage procedure on a parapharyngeal abscess.
7. A retropharyngeal abscess is drained by a provider using an intraoral approach.
8. A patient with a parapharyngeal abscess undergoes an incision and drainage procedure through the mouth.
9. An incision and drainage procedure is performed on a retropharyngeal abscess using an intraoral approach.
10. A provider uses an intraoral approach to perform an incision and drainage procedure on a parapharyngeal abscess.