2025 CPT code 42425
Effective Date: N/A Surgery - Surgical Procedures on the Digestive System Feed
Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve.
Modifiers may be applicable to this code. For example, modifier -50 (Bilateral Procedure) would be appended if the procedure was performed on both parotid glands during the same operative session. Other modifiers might be necessary depending on specific circumstances, such as unusual complexity (-22), or if the procedure was discontinued (-53).
Medical necessity is established by the presence of a parotid gland tumor. Documentation demonstrating the tumor's characteristics, such as size, location, and potential malignancy, should support the decision to perform a total parotidectomy with facial nerve sacrifice.
The surgeon is responsible for preparing the patient, administering anesthesia, performing the surgical excision, and closing the incision. They must have a detailed understanding of the parotid gland anatomy, including the facial nerve and its branches, to perform the procedure safely. The surgeon also manages post-operative care and any complications.
In simple words: This surgery removes the entire parotid salivary gland and a tumor within it. Because the tumor involves the facial nerve, the nerve needs to be removed as well. The surgeon makes an incision in front of the ear, extending down the neck and towards the jaw. They carefully remove the parotid gland and tumor together in one piece. Finally, the surgeon closes the incision with stitches.
This procedure involves the complete removal of the parotid gland along with the tumor as a single unit. The facial nerve is sacrificed during the procedure. A curvilinear incision is made from the preauricular area extending to the neck and towards the mid-jaw. The parotid gland is accessed, and the entire gland and tumor are removed en bloc (as one unit, within its capsule). The incision is then closed in layers with sutures.
Example 1: A patient presents with a malignant parotid gland tumor involving the facial nerve, requiring complete removal of the gland and sacrifice of the nerve (radical parotidectomy)., A patient has a large tumor within the parotid gland that distorts the anatomy, making facial nerve preservation impossible, thus necessitating a total parotidectomy with en bloc removal and sacrifice of the facial nerve., A patient with a recurrent pleomorphic adenoma involving the facial nerve undergoes total parotidectomy with sacrifice of the nerve to minimize risk of future recurrence.
Documentation should include details about the size and location of the tumor, its relationship with the facial nerve, operative findings, whether the tumor was completely excised, and any complications encountered. Pre-operative imaging (CT, MRI, or ultrasound) reports confirming the diagnosis and extent of the tumor should also be included. Pathology reports detailing the type and grade of the tumor are also essential.
- Global Days: 90 days
- Specialties:Otolaryngology, Head and Neck Surgery, Plastic Surgery
- Place of Service:Ambulatory Surgical Center, Inpatient Hospital, On Campus-Outpatient Hospital, Off Campus-Outpatient Hospital