CPT CODES

CPT Code 42660

CPT code 42660 is a medical code used to describe the procedure for dilating a salivary duct in healthcare billing and documentation.

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What is CPT Code 42660

CPT code 42660 is the procedure for dilation of a salivary duct. This involves the widening of a blocked or narrowed salivary duct to restore normal saliva flow. The procedure is typically performed to alleviate symptoms caused by duct obstruction, such as pain or swelling, and can help improve the patient's overall oral health.

Does CPT 42660 Need a Modifier?

For CPT code 42660 (Dilation of salivary duct), the following modifiers may be applicable:

1. Modifier 50 - Bilateral Procedure: Used if the dilation of salivary ducts is performed on both sides of the body during the same session.

2. Modifier 51 - Multiple Procedures: Applied when multiple procedures, including the dilation of the salivary duct, are performed during the same surgical session.

3. Modifier 52 - Reduced Services: Utilized if the procedure is partially reduced or eliminated at the physician's discretion.

4. Modifier 59 - Distinct Procedural Service: Indicates that the procedure is distinct or independent from other services performed on the same day.

5. Modifier 76 - Repeat Procedure by Same Physician: Used if the same procedure is repeated by the same physician on the same day.

6. Modifier 77 - Repeat Procedure by Another Physician: Applied if the same procedure is repeated by a different physician on the same day.

7. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: Used if the patient needs to return to the operating room for a related procedure during the postoperative period.

8. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Indicates that the procedure is unrelated to the original procedure and is performed during the postoperative period.

9. Modifier 80 - Assistant Surgeon: Used if an assistant surgeon is required during the procedure.

10. Modifier 81 - Minimum Assistant Surgeon: Applied if a minimum assistant surgeon is required during the procedure.

11. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Used when an assistant surgeon is necessary because a qualified resident surgeon is not available.

12. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: Indicates that a non-physician practitioner assisted in the surgery.

These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.

CPT Code 42660 Medicare Reimbursement

CPT code 42660 is reimbursed by Medicare. This code is listed on the Medicare Physician Fee Schedule (MPFS), indicating that it is a covered service. However, reimbursement may vary depending on the specific Medicare Administrative Contractor (MAC) in your region and any applicable local coverage determinations. It's important to verify coverage and reimbursement rates with your local MAC to ensure accurate billing and payment for this procedure.

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