© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 42340, known as sialolithotomy, involves the surgical removal of a calculus, or stone, from the parotid salivary gland or duct. This procedure is categorized as either extraoral or complicated intraoral, indicating that it may require more extensive surgical intervention compared to simpler cases. Sialolithotomy is specifically indicated when a calculus is lodged in a location that is difficult to access, necessitating careful dissection of surrounding tissues. This may include the identification and protection of critical anatomical structures such as nerves and blood vessels during the procedure. The term 'sialolithotomy' is often used interchangeably with 'sialolithomy,' although the latter typically refers to less complicated cases. In contrast to CPT® Code 42330, which pertains to uncomplicated intraoral procedures for calculus removal from the sublingual or parotid duct or gland, CPT® Code 42340 addresses more complex scenarios. These may involve multiple calculi or particularly large stones that complicate the surgical approach. The overall goal of the procedure is to alleviate symptoms associated with salivary gland obstruction and to restore normal salivary function.
© Copyright 2025 Coding Ahead. All rights reserved.
The sialolithotomy procedure, represented by CPT® Code 42340, is indicated for the removal of calculi from the parotid salivary gland or duct. The following conditions may warrant this surgical intervention:
The sialolithotomy procedure involves several critical steps to ensure the successful removal of the calculus from the parotid gland or duct. The following procedural steps are typically followed:
After the sialolithotomy procedure, patients can expect a recovery period that may vary depending on the complexity of the surgery and the individual’s overall health. Post-procedure care typically includes monitoring for any signs of infection or complications, such as excessive swelling or bleeding. Patients may be advised to follow a soft diet for a short period to minimize discomfort and allow the surgical site to heal. Pain management may be necessary, and the healthcare provider may prescribe analgesics as needed. Follow-up appointments are essential to assess healing and ensure that the salivary function is restored. Patients should be educated on signs of potential complications and instructed to seek medical attention if they experience any concerning symptoms.
| Short Descr | REMOVAL OF SALIVARY STONE | Medium Descr | SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL | Long Descr | Sialolithotomy; parotid, extraoral or complicated intraoral | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 33 - Other OR therapeutic procedures on nose, mouth and pharynx |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| Pre-1990 | Added | Code added. |
Get instant expert-level medical coding assistance.