{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:19:49Z","timestamp":1778854789779,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Identify unbundling trends in primary palatoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective study utilizing the American College of Surgeon Pediatric National Surgical Quality Improvement Program (PNSQIP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Records available from 2016 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>All patients with primary CPT (current procedural terminology) code 42200 (palatoplasty for cleft palate, soft and\/or hard palate only).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Cohorts compared \u201cunbundled\u201d: additional CPT code 42235 (repair of anterior palate, including vomer flap) vs. \u201cbundled\u201d: 42200 billed alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Operative time, surgical specialty, and other perioperative variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Plastic surgeons were less likely to unbundle (6.2% vs. otolaryngology, 9.12%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656241304213","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T02:49:37Z","timestamp":1734058177000},"page":"895-899","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Recognizing Variations in Primary Palatoplasty Billing: A Review of 9827 Cases"],"prefix":"10.1177","volume":"63","author":[{"given":"Ashlie A.","family":"Elver","sequence":"first","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wesley Q.","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy K.","family":"Perry","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Lewis","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura S.","family":"Humphries","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-2280","authenticated-orcid":false,"given":"Ian C.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"American Medical Association. 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