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The procedure described by CPT® Code 21141 involves the surgical reconstruction of the midface using a technique known as LeFort I osteotomy. This specific procedure is performed as a single piece segment movement, which allows for the repositioning of the maxilla, or upper jaw, in any direction. It is particularly indicated for patients with congenital facial bone deformities, such as Long Face Syndrome, or for cosmetic enhancements. The LeFort I osteotomy focuses on the lower maxillary region, which is anatomically defined as the area below the infraorbital nerve and medial to the zygomatic-maxillary suture. During the procedure, the physician does not utilize bone grafts, which distinguishes it from other reconstructive techniques that may require additional bone material for support or structure. The surgical approach includes careful manipulation of the maxilla, ensuring that the integrity of surrounding tissues is maintained while achieving the desired aesthetic and functional outcomes.
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The LeFort I osteotomy procedure, as described by CPT® Code 21141, is indicated for the following conditions:
The surgical steps involved in the LeFort I osteotomy are as follows:
After the LeFort I osteotomy, patients can expect a recovery period that may involve swelling, discomfort, and dietary modifications. Post-operative care typically includes pain management, monitoring for any complications, and follow-up appointments to assess healing and the positioning of the maxilla. Patients are advised to adhere to any specific instructions provided by the surgeon regarding activity restrictions and oral hygiene practices to ensure optimal recovery. The intermaxillary fixation device may remain in place for a specified duration, depending on the individual case and the surgeon's recommendations.
| Short Descr | LEFORT I-1 PIECE W/O GRAFT | Medium Descr | RCNSTJ MIDFACE LEFORT I 1 PIECE W/O BONE GRAFT | Long Descr | Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | 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 | 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). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| 2011-01-01 | Changed | Short description changed. |
| 1996-01-01 | Added | First appearance in code book in 1996. |
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