© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 21125 involves the augmentation of the mandibular body or angle using prosthetic material. This surgical intervention is typically performed to enhance the contour of the mandible, which may be necessary due to congenital deformities, trauma, or other conditions that affect the jaw's structure. During the procedure, the physician makes an incision either extraorally or at the angle of the mandible, allowing access to the underlying bone. A synthetic prosthesis is then carefully inserted onto the mandible. This prosthetic material is designed to provide support and improve the aesthetic appearance of the jawline. The prosthesis is secured in place using wires or screws to ensure stability and proper integration with the surrounding bone. This procedure is distinct from similar interventions, such as those involving bone grafts, which utilize the patient's own bone material for augmentation. The use of prosthetic material in this context allows for a more straightforward approach to achieving the desired contour of the mandible.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 21125 is indicated for various conditions that necessitate the augmentation of the mandibular body or angle. These indications may include:
The procedure for CPT® Code 21125 involves several key steps that ensure the successful augmentation of the mandibular body or angle:
Post-procedure care for patients undergoing augmentation of the mandibular body or angle with prosthetic material includes monitoring for any signs of complications, such as infection or improper healing. Patients are typically advised to follow specific postoperative instructions, which may include dietary modifications to avoid excessive strain on the jaw, pain management strategies, and follow-up appointments to assess healing and the stability of the prosthesis. The expected recovery period may vary depending on individual circumstances, but patients should be informed about the importance of adhering to the prescribed care plan to ensure optimal outcomes.
| Short Descr | AUGMENTATION MNDBLR PROSTC | Medium Descr | AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL | Long Descr | Augmentation, mandibular body or angle; prosthetic material | 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 | 2 | 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). | 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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2025-01-01 | Changed | Short Description changed. |
| 2011-01-01 | Changed | Short description changed. |
| 1991-01-01 | Added | First appearance in code book in 1991. |
Get instant expert-level medical coding assistance.