Summary & Overview
CPT 42340: Sialolithotomy, Removal of Parotid Gland Stone
CPT code 42340 denotes sialolithotomy, the surgical removal of a stone from a salivary gland, with the parotid gland commonly implicated. This procedure matters nationally because salivary gland obstructions can cause recurrent pain, infection, decreased oral function, and may require timely surgical intervention to prevent complications and restore quality of life. Clinically, sialolithotomy is a targeted, often minimally invasive head and neck procedure performed in outpatient surgical settings.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the code, benchmarks where available, and a summary of typical service settings and procedural intent. The publication outlines billing and documentation considerations tied to the procedure's surgical nature and expected sites of service, and it notes when input data were not provided.
What readers will learn: the clinical definition and typical use of CPT code 42340; primary sites of service and procedural setting; which major payers are included in payer coverage discussion; and where input data were unavailable. Data not provided in the input are clearly identified so users can seek supplemental payer-specific policy or coding guidance as needed.
Billing Code Overview
CPT code 42340 describes sialolithotomy, removal of a salivary gland stone, specifically referencing the parotid gland as a primary anatomic site. The procedure involves surgical extraction of a calculous obstruction from a salivary gland duct or gland to restore salivary flow and relieve obstruction-related symptoms.
Service type: surgical procedure, minor head and neck/oral surgery
Typical site of service: ambulatory surgical center, hospital outpatient department, or office-based surgical setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an otolaryngology clinic with unilateral swelling and pain in the floor of the mouth or preauricular area, worsened by meals. The clinician obtains a focused history (sudden salivary duct obstruction, prior sialadenitis, trauma, or history of stones) and performs an oral and head-and-neck exam, including palpation of the affected salivary gland and duct. Imaging such as a noncontrast CT of the neck, ultrasound, or sialography is ordered to localize a sialolith within the submandibular or parotid duct. Conservative measures (hydration, sialogogues, massage, antibiotics if infected) are attempted first when appropriate. When a discrete stone is accessible and conservative therapy fails or infection/obstruction persists, the patient is scheduled for a sialolithotomy under local anesthesia with sedation or general anesthesia depending on stone location, size, and patient comorbidity. The procedure is performed in an ambulatory surgery center or hospital operating room for deeper parotid or intra-glandular stones, or in an outpatient clinic procedure room for anterior duct stones. Postoperative care includes pain control, antibiotics if indicated, instructions for sialogogues, and a follow-up visit to assess ductal patency and healing. Documentation includes operative note with 42340 as the performed procedure, stone size and location, anesthesia type, any complications, and applicable modifier codes for billing and payer adjudication.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |