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CPT®
42508

CPT® Code 42508
Deleted

Official Description

Parotid duct diversion, bilateral (Wilke type procedure); with excision of 1 submandibular gland

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A bilateral parotid duct diversion, commonly known as a Wilke procedure, is a surgical intervention aimed at addressing excessive salivation, medically referred to as sialorrhea. This condition often leads to uncontrolled drooling, which can significantly impact a patient's quality of life. Sialorrhea is frequently associated with neurological disorders, such as cerebral palsy or traumatic brain injuries, which can disrupt the normal regulation of saliva production. The primary salivary glands involved in this process are the parotid, submandibular, and sublingual glands. During the procedure, the parotid ducts are meticulously dissected from the surrounding tissues, preserving a cuff of mucosa. This allows for the transposition of the ducts to the tonsillar fossae, where they are secured with sutures to redirect saliva away from the oral cavity. In the case of CPT® Code 42508, the procedure includes the excision of one submandibular gland, which further aids in reducing saliva production. The surgical approach involves making an incision in the upper neck, just below the mandible, to access and remove the submandibular gland while carefully protecting the marginal mandibular branch of the facial nerve. This comprehensive approach not only alleviates the symptoms of sialorrhea but also addresses the underlying anatomical factors contributing to the condition.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The bilateral parotid duct diversion procedure, as described by CPT® Code 42508, is indicated for patients experiencing excessive salivation, known as sialorrhea. This condition is often a result of neurological deficits, which may include:

  • Cerebral Palsy A neurological disorder that affects movement and muscle coordination, leading to difficulties in controlling saliva production.
  • Head Injury Trauma to the brain that can disrupt normal salivary function and regulation, resulting in uncontrolled drooling.

2. Procedure

The procedure for bilateral parotid duct diversion with excision of one submandibular gland involves several detailed steps:

  • Step 1: Incision An incision is made in the upper aspect of the neck, just below the mandible, to provide access to the submandibular glands.
  • Step 2: Exposure of Submandibular Gland The surgeon carefully dissects the tissue to expose one or both submandibular glands, ensuring that the marginal mandibular branch of the facial nerve is protected throughout the process.
  • Step 3: Duct Ligation and Division The submandibular duct is then suture ligated and divided, which is a critical step in the removal of the gland.
  • Step 4: Gland Excision The submandibular gland(s) are removed from the surgical site, which helps in reducing saliva production.
  • Step 5: Drain Placement A drain is placed in the surgical wound to facilitate fluid drainage and prevent complications.
  • Step 6: Wound Closure Finally, the incision is closed around the drain, completing the surgical procedure.

3. Post-Procedure

After the bilateral parotid duct diversion procedure, patients may require specific post-operative care to ensure proper healing and recovery. This includes monitoring for any signs of infection at the incision site, managing pain with prescribed medications, and following up with the healthcare provider to assess the success of the procedure. Patients may also be advised on dietary modifications to accommodate any changes in saliva production and to facilitate recovery. It is essential to keep the surgical area clean and to follow any additional instructions provided by the healthcare team to promote optimal healing.
Short Descr PAROTID DUCT DIVERSION
Medium Descr PAROTID DUCT DIVERSION BI W/EXC 1 SUBMNDBLR GLND
Long Descr Parotid duct diversion, bilateral (Wilke type procedure); with excision of 1 submandibular gland
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) 2 - 150% payment adjustment does NOT apply.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply 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 Procedure or Service, Multiple Reduction Applies
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE Not applicable/unspecified.
CCS Clinical Classification 33 - Other OR therapeutic procedures on nose, mouth and pharynx
Date
Action
Notes
2015-01-01 Deleted Code deleted
2010-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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