CPT® Code 42845

The CPT® Code 42845 refers to a surgical procedure known as a radical resection of the tonsil, tonsillar pillars, and/or retromolar trigone, with closure achieved using a different type of flap. This procedure is primarily indicated for the treatment of primary malignant neoplasms located in the oropharynx, specifically in the tonsils, tonsillar pillars, and retromolar trigone areas. The tonsils, particularly the palatine tonsils, are clusters of lymphoid tissue located laterally at the back of the throat, nestled between the anterior and posterior tonsillar pillars, which are formed by the palatoglossus and palatopharyngeus muscles, respectively. The retromolar trigone is a small mucosal region situated behind the wisdom teeth. During the procedure, the extent of the tumor is assessed through various diagnostic studies, including radiographic imaging and biopsies, to determine the precise area that requires resection. The surgical approach may involve either an oral route or a neck incision, depending on the tumor's location and extent. The surgeon excises the tumor along with a margin of healthy tissue to ensure complete removal of malignant cells. To confirm the absence of cancerous tissue, frozen sections are sent for laboratory analysis during the procedure. If any malignant tissue remains, further excision is performed until clear margins are achieved. In contrast to other related procedures, such as CPT® Code 42842, where the resection site is left to heal naturally, or CPT® Code 42844, which involves local flap closure using adjacent tissue, CPT® Code 42845 utilizes a different flap technique. This involves harvesting tissue from another area of the body, which is then shaped and sutured into place over the surgical site in the oropharynx using microvascular techniques. The donor site from which the flap is taken is also sutured to facilitate healing.