CPT® Code 42120

The procedure described by CPT® Code 42120 involves the resection of the palate or an extensive resection of a lesion located on the hard or soft palate. This surgical intervention is primarily indicated for the removal of benign tumors, as well as premalignant or malignant lesions that may affect the palate's integrity and function. The process begins with the creation of a mucosal incision that outlines the periphery of the lesion or the specific area of the palate that requires resection. In cases where the lesion is situated in the soft palate, the incision extends through the submucosal and connective tissue layers, allowing for the removal of the affected region along with a margin of healthy tissue to ensure complete excision. Conversely, if the lesion involves the hard palate, the incision penetrates through the periosteum, which is then elevated to access the underlying bone. An osteotome or oscillating saw is employed to cut through the affected bone, facilitating the removal of the lesion along with an adequate margin of healthy tissue. The excised tissue is subsequently sent for pathology examination to assess the nature of the lesion. After the resection, the surgical defect may be closed using lateral relaxing incisions and a local mucosal advancement flap, with primary closure of the donor site. In instances where larger defects are present, a local palatal flap may be utilized, allowing the donor site to heal by secondary intention. Additionally, for reconstruction purposes, separately reportable extraoral tissue grafts may be employed. It is important to note that the excision of bone typically necessitates separate reporting for reconstruction using a palatal obturator, highlighting the complexity and comprehensive nature of this surgical procedure.