2025 CPT code 42900
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Digestive System Surgery Feed
Suturing a wound or injury in the pharynx.
Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT manual for specific modifier guidelines.
Medical necessity for CPT code 42900 is established when a patient presents with a pharyngeal laceration requiring surgical repair to restore anatomical integrity, prevent infection, and manage complications such as bleeding and airway compromise.
The physician is responsible for the surgical repair of the pharyngeal wound, including wound assessment,surgical technique (suture ligature), hemostasis (bleeding control), and postoperative care.This may involve coordination with anesthesia and other support staff.
In simple words: The doctor repairs a cut or tear in the back of the throat using stitches.They carefully close the wound and stop any bleeding.
This CPT code, 42900, represents the surgical repair of a pharyngeal wound or injury using sutures.The procedure involves meticulous closure of the lacerated pharyngeal mucosa, often employing a suture ligature technique for pharyngeal reconstruction or reconfiguration.Hemostasis, or the control of bleeding, is typically achieved using bipolar electrocautery.
Example 1: A patient presents to the emergency department after a motor vehicle accident with a deep laceration to the pharynx. The physician performs a surgical repair using sutures and electrocautery to control bleeding. , A patient undergoes a tonsillectomy, and an unexpected laceration occurs during the procedure. The surgeon uses CPT code 42900 to document the repair of the pharyngeal injury., During a routine endoscopic procedure, a biopsy forceps causes a small tear in the patient's pharynx.The physician utilizes sutures to repair this iatrogenic (doctor-caused) injury.
* Detailed operative report describing the procedure, including type and number of sutures used.* Preoperative and postoperative photographs documenting the wound's extent and repair.* Documentation of bleeding control techniques employed (e.g., electrocautery).* Anesthesia records, if applicable.* Patient's medical history and pertinent physical examination findings.
** Always ensure accurate documentation to support medical necessity and proper coding. Refer to the most current CPT manual and payer specific guidelines for the most up-to-date information.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: Information not available in provided source. Refer to CMS guidelines and local payer policies for RVU values.
- Global Days: Information not available in provided source.The global period will vary depending on payer and other factors.Consult the payer's specific guidelines.
- Payment Status: Active
- Modifier TC rule: Information not available in the provided source. The applicability of TC modifier depends on the circumstances of service and should be determined using payer specific guidelines.
- Fee Schedule: Historical fee schedule data is not provided. This will vary based on geographic location and payer.
- Specialties:Otolaryngology, General Surgery
- Place of Service:Office, Hospital Inpatient, Hospital Outpatient, Ambulatory Surgery Center