Find policies, billing codes, payers, states, and providers
CPT 42182: Complex Repair of Palatal Wound
CPT code 42182 denotes complex repair of a palatal wound larger than 2 cm or requiring advanced techniques such as debridement or undermining. Nationally, this code captures surgical care for moderate-to-complex palatal soft-tissue injuries and is relevant to otolaryngology, oral and maxillofacial surgery, and related surgical specialties. Proper coding affects clinical documentation, hospital outpatient and ambulatory surgical center billing, and aggregated utilization metrics.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage and payment policies for complex oral soft-tissue repairs vary by payer and site of service; providers commonly encounter this code in hospital outpatient departments and ambulatory surgical centers.
Readers will find a concise explanation of the clinical intent of 42182, the typical settings where the service is delivered, and an outline of the payer landscape covered. The publication summarizes benchmarks and reimbursement context where available, highlights coding and documentation considerations tied to wound size and complexity, and provides clinical context for when this code is used. Data not available in the input is noted where applicable.
Customize your policy alerts
Sign up for cpt 42182 policy alerts
Get alerted when payer policies referencing 42182 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 42182 describes repair of a wound of the palate that is greater than 2 cm in size or requires complex repair techniques such as debridement or undermining of damaged tissues. This procedure is a surgical soft-tissue repair focused on the oral cavity palate.
-
Service type: Complex wound repair of the palate involving significant tissue handling and reconstruction.
-
Typical site of service: Hospital outpatient department or ambulatory surgical center; may also be performed in an operating room setting when indicated.