CPT® Code 42844

The procedure described by CPT® Code 42844 involves a radical resection of the tonsil, tonsillar pillars, and/or retromolar trigone, which are critical areas in the oropharynx where primary malignant neoplasms commonly occur. The tonsils, specifically the palatine tonsils, are clusters of lymphoid tissue located laterally at the back of the throat, nestled between the anterior and posterior tonsillar pillars. The anterior tonsillar pillar is formed by the palatoglossus muscle, while the posterior pillar is formed by the palatopharyngeus muscle. The retromolar trigone is a small mucosal region located behind the wisdom teeth. The procedure is typically indicated when there is a malignant tumor present in these areas, and the extent of the tumor is assessed through various diagnostic studies, including radiographic imaging and biopsies. During the surgery, the physician identifies the tumor and performs a complete resection, ensuring that a margin of healthy tissue is included to minimize the risk of residual malignancy. The resection can be approached either orally or through a neck incision, depending on the tumor's location and extent. To confirm the complete removal of malignant tissue, frozen sections are sent for laboratory analysis during the procedure. If any malignant tissue remains, further excision is performed. Unlike CPT® Code 42842, where the resection site is left to heal by secondary intention, CPT® Code 42844 includes the closure of the surgical site using a local flap. This involves mobilizing adjacent tissue, such as from the tongue or buccal area, which is then rotated over the resection site and sutured in place, with the donor site also being sutured for closure.