How To Use CPT Code 42892

CPT 42892 describes the resection of the lateral pharyngeal wall or pyriform sinus, with closure achieved by advancing the lateral and posterior pharyngeal walls. 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 42892?

CPT 42892 can be used to describe a surgical procedure in which a portion of the lateral pharyngeal wall or pyriform sinus is removed. The wound is then closed by advancing the lateral and posterior pharyngeal walls. This code is used to report the resection and closure of these specific areas in the oral cavity and pharynx.

2. Official Description

The official description of CPT code 42892 is: ‘Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls.’

3. Procedure

1. The provider begins by assessing the pathological condition in the oral cavity and pharynx that requires surgical intervention.
2. A portion of the lateral pharyngeal wall or pyriform sinus is surgically removed.
3. The provider then closes the wound by advancing the lateral and posterior pharyngeal walls using an advancement flaps technique.

4. Qualifying circumstances

CPT 42892 is used when there is a need to remove a portion of the lateral pharyngeal wall or pyriform sinus and close the wound by advancing the lateral and posterior pharyngeal walls. This procedure is typically performed to treat specific pathological conditions in the oral cavity and pharynx. It is important to note that when combined with radical neck dissection, CPT code 38720 should also be used.

5. When to use CPT code 42892

CPT code 42892 should be used when a provider performs the resection of the lateral pharyngeal wall or pyriform sinus and achieves closure by advancing the lateral and posterior pharyngeal walls. This code accurately represents the specific procedure performed and allows for proper documentation and billing.

6. Documentation requirements

To support a claim for CPT code 42892, the provider must document the following information:

• The specific pathological condition in the oral cavity and pharynx that necessitated the resection
• The technique used to close the wound by advancing the lateral and posterior pharyngeal walls

7. Billing guidelines

When billing for CPT code 42892, ensure that the procedure performed aligns with the description of the code. It is important to accurately document the specific pathological condition and the closure technique used. Additionally, if the resection is performed in conjunction with radical neck dissection, CPT code 38720 should also be reported.

8. Historical information

CPT code 42892 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 the resection of the lateral pharyngeal wall to treat a patient with a tumor in that area. The wound is closed by advancing the lateral and posterior pharyngeal walls.
2. During a surgical procedure, a provider removes a portion of the pyriform sinus and achieves closure by advancing the lateral and posterior pharyngeal walls.
3. A patient presents with a pathological condition in the oral cavity that requires the resection of the lateral pharyngeal wall. The provider performs the procedure and closes the wound using an advancement flaps technique.
4. As part of the treatment plan for a specific pathological condition, a provider performs the resection of the pyriform sinus and achieves closure by advancing the lateral and posterior pharyngeal walls.
5. A provider performs the resection of the lateral pharyngeal wall to address a pathological condition in the oral cavity. The wound is closed by advancing the lateral and posterior pharyngeal walls.
6. During a surgical procedure, a portion of the pyriform sinus is removed by a provider. The lateral and posterior pharyngeal walls are then advanced to achieve closure.
7. A patient undergoes the resection of the lateral pharyngeal wall to treat a specific pathological condition. The provider closes the wound by advancing the lateral and posterior pharyngeal walls.
8. As part of a surgical intervention, a provider removes a portion of the pyriform sinus and achieves closure by advancing the lateral and posterior pharyngeal walls.
9. A provider performs the resection of the lateral pharyngeal wall to address a pathological condition in the oral cavity. The wound is closed using an advancement flaps technique.
10. During a surgical procedure, a patient undergoes the resection of the pyriform sinus. The provider achieves closure by advancing the lateral and posterior pharyngeal walls.