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The procedure described by CPT® Code 21088 involves the creation of a facial prosthesis tailored specifically for the patient. This process begins with the physician taking precise molds of the patient's face, which serve as the foundation for the prosthesis. These molds are critical as they ensure that the prosthesis fits comfortably and accurately on the patient's facial structure. The resulting facial prosthesis is typically made from latex, a material chosen for its flexibility and durability. Once the prosthesis is crafted, it can be affixed to the patient's face using either adhesive or magnets, depending on the specific requirements and preferences of the patient and physician. Additionally, to enhance the accuracy and aesthetic appeal of the prosthesis, photographs of the patient are utilized. These images assist the physician in creating a nasal prosthesis that closely resembles the patient's appearance prior to any surgical interventions, ensuring a more natural and harmonious look. Overall, this procedure is essential for patients who require facial reconstruction or enhancement due to various medical conditions or surgical outcomes.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure associated with CPT® Code 21088 is indicated for patients who require a facial prosthesis due to various conditions or circumstances. These may include:
The procedure for creating a facial prosthesis involves several detailed steps to ensure a precise and effective outcome. Each step is crucial for achieving a prosthesis that meets the patient's needs.
After the procedure, patients may require specific post-procedure care to ensure the proper healing and functionality of the facial prosthesis. It is important for patients to follow the physician's instructions regarding the care and maintenance of the prosthesis. This may include guidelines on how to clean the prosthesis, how to apply or remove it safely, and recommendations for regular follow-up appointments to assess the fit and condition of the prosthesis. Patients should also be advised to monitor for any signs of irritation or discomfort and to report these to their physician promptly. Overall, the post-procedure phase is essential for ensuring the long-term success and satisfaction with the facial prosthesis.
| Short Descr | IMPRES&PREP FACIAL PROSTH | Medium Descr | IMPRESSION & PREPARATION FACIAL PROSTHESIS | Long Descr | Impression and custom preparation; facial prosthesis | Status Code | Carriers Price the Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P6B - Minor procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 32 - Other non-OR therapeutic procedures on nose, mouth and pharynx |
| 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) |
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| 2025-01-01 | Changed | Short Description changed. |
| 2013-01-01 | Changed | Medium Descriptor changed. |
| 1991-01-01 | Added | First appearance in code book in 1991. |
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