© Copyright 2025 American Medical Association. All rights reserved.
Genioplasty is a surgical procedure aimed at correcting the bony contour of the chin through the technique of sliding osteotomy. This procedure is particularly beneficial for patients with asymmetrical chins, where the chin may be either receding or protruding. The surgery begins with an incision made in the gingivolabial sulcus, which allows access to the underlying bone structure. Once the incision is made, the periosteum, a dense layer of connective tissue that covers the bones, is exposed. A subperiosteal dissection is then performed laterally from the midline of the chin until the mental nerves, which are responsible for sensation in the lower lip and chin, are identified and preserved. The placement of the bone cuts is carefully determined based on the specific needs of the patient. The mandible, or lower jawbone, is then cut on each side using a sagittal saw, allowing for precise adjustments to the chin's position. Depending on the patient's condition, the chin may be advanced (moved forward) or retruded (moved backward) to achieve the desired aesthetic outcome. Once the bone is repositioned, it is secured in place using wires or a plate and screw device to ensure stability during the healing process. Finally, the overlying soft tissues are meticulously closed in layers to promote optimal healing and minimize scarring. This procedure is distinct from other types of genioplasty, such as a single piece sliding osteotomy, which involves fewer bone cuts, and is specifically indicated when multiple cuts are necessary for reshaping an asymmetrical chin.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure of genioplasty, specifically the sliding osteotomy with two or more osteotomies, is indicated for the following conditions:
The genioplasty procedure involves several critical steps to ensure successful outcomes. First, an incision is made in the gingivolabial sulcus, which is the groove between the gums and the lip. This incision allows the surgeon to access the underlying bone while minimizing visible scarring. Following the incision, the periosteum is carefully exposed, providing a clear view of the mandible. The surgeon then performs a subperiosteal dissection, which involves gently separating the periosteum from the bone laterally from the midline until the mental nerves are identified. This step is crucial for preserving nerve function and sensation in the lower lip and chin. Next, the surgeon determines the placement of the bone cuts based on the specific anatomical considerations of the patient. Using a sagittal saw, the mandible is cut on each side, allowing for the necessary adjustments to the chin's position. Depending on the patient's needs, the chin may be advanced or retruded. Once the desired position is achieved, the bone is secured using wires or a plate and screw device, ensuring that it remains stable during the healing process. Finally, the overlying soft tissues are closed in layers, which aids in recovery and minimizes complications.
After the genioplasty procedure, patients can expect a recovery period that may involve swelling and discomfort in the chin area. Post-operative care typically includes pain management, maintaining oral hygiene, and following specific dietary restrictions to avoid strain on the surgical site. Patients are advised to avoid strenuous activities and follow-up appointments are essential to monitor healing and ensure that the bone is properly secured in its new position. The surgeon may provide additional instructions regarding the care of the incision site and any necessary follow-up imaging to assess the results of the surgery.
| Short Descr | GENIOP SLDG OSTEOT 2/> | Medium Descr | GENIOPLASTY SLIDING OSTEOTOMIES 2/> | Long Descr | Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard 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) | 2 - Payment restriction for assistants at surgery does not apply 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 161 - Other OR therapeutic procedures on bone |
| 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | KX | Requirements specified in the medical policy have been met |
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| 2025-01-01 | Changed | Short and Medium Descriptions changed. |
| 2009-01-01 | Changed | Code description changed |
| 1991-01-01 | Added | First appearance in code book in 1991. |
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