Summary & Overview
CPT 42420: Parotidectomy with Facial Nerve Dissection and Preservation
CPT code 42420 represents parotidectomy for tumor removal with dissection and preservation of the facial nerve — a cornerstone procedure in head and neck surgical oncology. Nationally, this code is important because it captures care for patients with parotid tumors where nerve-sparing techniques are critical to functional outcomes and long-term quality of life. Accurate coding supports appropriate clinical documentation, appropriate reimbursement, and tracking of outcomes tied to complex head and neck surgery.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus benchmarking and coding context where available. The publication summarizes common billing practices, typical use cases for the code in operative management of parotid tumors, and implications for surgical documentation. It also flags where input data are missing and what national audiences should consider when reviewing claims and policy guidance related to this procedure.
The content is organized for clinicians, coding professionals, and policy analysts seeking clear, national-level information on CPT code 42420, including benchmarks, policy updates, and clinical considerations relevant to parotid tumor surgery and facial nerve preservation.
Billing Code Overview
CPT code 42420 describes a surgical procedure in which the provider removes a parotid gland containing a tumor with dissection and preservation of the facial nerve. This procedure is a parotidectomy with facial nerve dissection and preservation.
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Service type: Surgical procedure — head and neck surgery
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Typical site of service: Hospital operating room or ambulatory surgery center
This code applies when the parotid gland is removed for tumor management and the facial nerve is carefully identified, dissected, and preserved during the operation.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 55-year-old adult presenting with a slowly enlarging, painless mass over the preauricular region. Imaging (ultrasound and contrast-enhanced MRI or CT) and fine-needle aspiration suggest a parotid neoplasm suspicious for malignancy or a benign tumor causing cosmetic or functional concerns. The patient undergoes preoperative evaluation including history, physical exam focused on facial nerve function, laboratory studies, and anesthesia assessment. In the operating room under general anesthesia, the surgeon performs a parotidectomy with careful dissection and identification of the facial nerve branches, removes the tumor-bearing gland or portion of the gland, and preserves motor function of the facial nerve when feasible. Intraoperative nerve monitoring may be used. Postoperative care includes facial nerve function assessment, wound care, pain control, and pathology review to determine need for adjuvant therapy such as radiation. Typical site of service is an inpatient or outpatient hospital operating room or ambulatory surgery center. Service type: surgical, otolaryngology/head and neck surgical procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Normal value — not a standard CMS modifier (placeholder in list) | Data not available in the input; not used for billing purposes |
11 |