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Official Description

Palatoplasty for cleft palate; major revision

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Palatoplasty for cleft palate, specifically coded as CPT® 42215, refers to a surgical procedure aimed at correcting a cleft palate through a major revision of a previous palatoplasty. This procedure is typically performed when initial surgical interventions have not fully addressed the defect, necessitating a secondary operation to enhance the patient's quality of life. The primary goals of this surgery include the closure of the palatal defect and the restoration of optimal velopharyngeal function, which is crucial for normal eating, breathing, and speech intelligibility. In many cases, patients may require additional surgical interventions, such as a secondary lengthening procedure or the attachment of a pharyngeal flap, to achieve these objectives. The complexity of the procedure is determined by the specific characteristics of the residual defect, and the surgeon will evaluate the postoperative outcomes of the initial surgery to guide the revision process. During the operation, various types of tissue, including mucosa, submucosa, mucoperiosteum, and muscle, are meticulously rearranged to effectively close the defect and improve functional outcomes.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Palatoplasty for cleft palate, coded as CPT® 42215, is indicated for patients who have previously undergone palatoplasty but require a major revision due to residual defects. The following conditions may warrant this procedure:

  • Residual Cleft Palate Defect A significant defect remains after the initial surgical repair, necessitating further intervention to achieve closure.
  • Velopharyngeal Insufficiency The patient experiences inadequate closure of the velopharyngeal port, leading to speech difficulties and potential feeding issues.
  • Functional Impairments The patient may have ongoing challenges with normal eating, breathing, or speech intelligibility that require surgical correction.

2. Procedure

The procedure for CPT® 42215 involves several critical steps to ensure effective revision of the cleft palate. The following outlines the procedural steps:

  • Assessment of the Residual Defect The surgeon begins by evaluating the postoperative deficits from the initial palatoplasty. This assessment is crucial for determining the specific approach needed for the revision.
  • Rearrangement of Tissue Once the assessment is complete, the surgeon proceeds to rearrange various types of tissue, including mucosa, submucosa, mucoperiosteum, and muscle, to effectively close the defect. This step is tailored to the unique characteristics of the residual cleft.
  • Closure of the Defect The surgeon meticulously sutures the rearranged tissues to ensure a secure closure of the palatal defect, aiming to restore normal function and appearance.

3. Post-Procedure

After the completion of the palatoplasty for cleft palate, patients typically require careful monitoring and follow-up care. Post-procedure care may include pain management, dietary modifications to accommodate healing, and speech therapy to address any ongoing communication challenges. The expected recovery period varies depending on the extent of the revision and the individual patient's healing process. Regular follow-up appointments are essential to assess the surgical outcomes and to determine if additional interventions are necessary for optimal functional results.

Short Descr RECONSTRUCT CLEFT PALATE
Medium Descr PALATOPLASTY CLEFT PALATE MAJOR REVJ
Long Descr Palatoplasty for cleft palate; major revision
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE 1
CCS Clinical Classification 33 - Other OR therapeutic procedures on nose, mouth and pharynx
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
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Pre-1990 Added Code added.
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