AHA Coding Clinic® for HCPCS - 2026 Issue 1; Ask the Editor

Endoscopic Dilation of Salivary Duct

A patient with recurrent left parotid swelling presents for dilation via sialoendoscope. The papilla to Stenson’s duct was located and dilated up to the size 8.0 dilator without issue. The 1.6 mm sialoendoscope was placed into the duct but was unable to be safely advanced beyond 2 cm. The lumen was then identified, however after continued resistance, the 1.6 mm scope was removed, and a 1.3 mm scope was set up and placed into the papillae removing sludge from the lumen. With continued difficulty advancing the scope, we could not maintain an adequate view of the lumen to determine if there was a true stenosis or not. Therefore, it was decided not to advance the scope further due to continued resistance. The 2 ml of Kenalog 40mg/mL was injected under direct visualization. The patient returned to anesthesia for extubation, and the procedure was concluded. There is no CPT code that specifically describes endoscopic dilation of the salivary duct. What is the appropriate CPT code for endoscopic salivary duct dilation with steroid injection? May CPT code 42660 be reported when the procedure is performed endoscopically, even though an endoscope is not referenced in the code descriptor? ...

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