How To Use CPT Code 42725

CPT 42725 describes the procedure of incision and drainage of a retropharyngeal or parapharyngeal abscess using an external approach. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 42725?

CPT 42725 is used to describe the incision and drainage procedure for a retropharyngeal or parapharyngeal abscess. In this particular case, the abscess is drained using an external approach. The physician makes an incision in the neck, either at the anterior or posterior border of the sternocleidomastoid muscle, to access the abscess. The procedure involves breaking down the abscess using a hemostat and securing a drainage device or tube at the abscess site for continuous drainage. Antibiotics may be applied, and packing or closure may be performed as necessary.

2. Official Description

The official description of CPT code 42725 is: ‘Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach.’

3. Procedure

1. The physician administers anesthesia to the patient.
2. An incision is made in the neck at the anterior or posterior border of the sternocleidomastoid muscle.
3. The incision is extended to access the retropharyngeal or parapharyngeal abscess.
4. A hemostat is used to break down the abscess.
5. A drainage device or tube is secured at the abscess site for continuous drainage.
6. Antibiotics may be applied, and packing or closure may be performed.

4. Qualifying circumstances

CPT 42725 is performed when there is a retropharyngeal or parapharyngeal abscess that requires drainage. The procedure is done externally, and the physician makes an incision in the neck to access the abscess. This code is used for cases where the abscess is located in the retropharyngeal or parapharyngeal space.

5. When to use CPT code 42725

CPT code 42725 should be used when a retropharyngeal or parapharyngeal abscess requires drainage and the procedure is performed using an external approach. It is important to accurately document the location of the abscess and the approach used during the procedure.

6. Documentation requirements

To support a claim for CPT 42725, the physician must document the following information:

• Diagnosis of a retropharyngeal or parapharyngeal abscess
• Location of the abscess
• Details of the procedure, including the approach used
• Use of anesthesia
• Application of antibiotics, packing, or closure, if performed
• Signature of the performing physician

7. Billing guidelines

When billing for CPT 42725, ensure that the procedure involves the incision and drainage of a retropharyngeal or parapharyngeal abscess using an external approach. It is important to accurately document the details of the procedure and any additional services provided, such as anesthesia or application of antibiotics. Follow the appropriate coding guidelines and modifiers when reporting this code.

8. Historical information

CPT 42725 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 physician performing an incision and drainage procedure for a retropharyngeal abscess using an external approach.
2. A surgeon making an incision to drain a parapharyngeal abscess via an external approach.
3. A specialist performing an incision and drainage procedure for a retropharyngeal abscess in a pediatric patient.
4. A physician using an external approach to drain a parapharyngeal abscess in an adult patient.
5. A surgeon performing an incision and drainage procedure for a retropharyngeal abscess in a patient with a compromised immune system.
6. A specialist making an incision to drain a parapharyngeal abscess in a patient with recurrent infections.
7. A physician performing an incision and drainage procedure for a retropharyngeal abscess in a patient with severe throat pain.
8. A surgeon using an external approach to drain a parapharyngeal abscess in a patient with difficulty swallowing.
9. A specialist making an incision to drain a retropharyngeal abscess in a patient with a history of head and neck cancer.
10. A physician performing an incision and drainage procedure for a parapharyngeal abscess in a patient with a foreign body lodged in the throat.