Wiki parotidectomy with extension into the parapharyngeal space

[kmiller177]

Head and Neck surgeons wish to bill their total parotidectomies with skull base CPT codes 61590 and 61605. The intent of the procedure is removal of the parotid gland, but the gland is either large and extending into or has additional tumor that extends into the parapharyngeal space. There is no craniotomy being performed. Does anyone have a similar issue? They are quite adamant about the additional work and do not feel adding a 22 to the parotidectomy codes is enough.
Thank you in advance!