Abstract
Objective
Identify unbundling trends in primary palatoplasty.
Design
Retrospective study utilizing the American College of Surgeon Pediatric National Surgical Quality Improvement Program (PNSQIP).
Setting
Records available from 2016 to 2021.
Patients
All patients with primary CPT (current procedural terminology) code 42200 (palatoplasty for cleft palate, soft and/or hard palate only).
Interventions
Cohorts compared “unbundled”: additional CPT code 42235 (repair of anterior palate, including vomer flap) vs. “bundled”: 42200 billed alone.
Main outcome measures
Operative time, surgical specialty, and other perioperative variables.
Results
In total, 9827 had primary CPT 42200. Of these, 671 (6.8%) were unbundled. Operative time was longer in unbundled (157.08 min vs. 133.16 min; P < .001). Plastic surgeons were less likely to unbundle (6.2% vs. otolaryngology, 9.12%; P < .001).
Conclusions
Variations in primary palatoplasty billing exist. Longer operative times in unbundled cases suggest added complexity. Undervaluation of craniofacial CPT codes may contribute to non-standard billing practices.
Keywords
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