Summary & Overview
CPT 4255F: No Summary Available
CPT code 4255F is listed without an available clinical summary. As a CPT performance/measure code identifier, it represents a discrete billing entry used in clinical documentation and claims processing; the specific clinical action or measure associated with this code was not provided in the input. Nationally, precise definitions for CPT codes matter for consistent reporting, quality measurement, and claims adjudication across payers.
Key payers referenced in this context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of what the code represents, the expected areas of application, and where to look for supplementary information. The publication outlines typical components readers should expect in a full code brief: clinical context, service type, typical site of service, payer coverage patterns, benchmarking considerations, and related billing guidance.
This national summary does not include state-level detail. Where source data were not provided, the text clearly notes missing elements and directs readers to seek the official CPT code set and payer policy manuals for authoritative definitions and usage guidance.
Billing Code Overview
CPT code 4255F — No Summary found for this code
Service type: Data not available in the input.
Typical site of service: Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an otolaryngology or maxillofacial surgery clinic with progressive salivary gland obstruction or suspected sialolithiasis causing recurrent pain and swelling of the submandibular gland, often worse with meals. The clinical workflow begins with history and physical exam, followed by imaging such as ultrasound or CT to identify stones or ductal narrowing. When conservative measures (sialagogues, hydration, antibiotics for infection) fail or stones are inaccessible to manual expression, the patient is scheduled for a minimally invasive procedure under local anesthesia with sedation or general anesthesia in an ambulatory surgery center or hospital outpatient department. Intraoperative steps include endoscopic visualization of the duct, stone retrieval with baskets or graspers, possible duct dilation, and irrigation. Post-procedure care includes short observation for bleeding or airway compromise, analgesia, oral antibiotics if infected, sialogogues, and outpatient follow-up to assess gland function and wound healing. Typical sites of service are the ambulatory surgery center, hospital outpatient department, or specialty clinic procedural suite. Providers commonly involved are otolaryngologists (ENT), oral and maxillofacial surgeons, and interventional radiologists when image guidance is required.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service by the same physician on the day of a procedure | Use when a distinct E/M visit is performed on the same day as the procedure and is documented separately. |