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The procedure described by CPT® Code 21181 involves the surgical reconstruction of cranial bones that have been affected by a benign tumor, such as fibrous dysplasia. This condition leads to abnormal growth and development of bone tissue, which can result in deformities or structural issues within the skull. The reconstruction process is performed through contouring, which means that the surgeon reshapes the cranial bones to restore their normal appearance and function. To access the tumor site, the physician makes several incisions in the scalp, allowing for direct visualization and manipulation of the underlying bone. During the contouring process, specialized surgical instruments such as burs, osteotomes, files, and saws are utilized to carefully reshape the cranial bone to achieve the desired contour. After the contouring is completed, the incisions are meticulously closed in layers to promote optimal healing and minimize scarring. This procedure is essential for addressing the complications associated with benign tumors of the cranial bones and restoring the structural integrity of the skull.
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The procedure is indicated for the treatment of benign tumors of the cranial bones, which may include conditions such as:
The procedure involves several critical steps to ensure effective reconstruction of the cranial bones affected by the benign tumor.
Post-procedure care typically involves monitoring the patient for any signs of complications, such as infection or excessive bleeding. Patients may be advised to rest and limit physical activity during the initial recovery period. Follow-up appointments are essential to assess the healing process and ensure that the cranial bones are healing properly. Pain management may also be provided as needed, and patients should be educated on signs of complications that would require immediate medical attention.
| Short Descr | CONTOUR CRANIAL BONE LESION | Medium Descr | RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC | Long Descr | Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial | 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) | 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 | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | 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). | 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. | 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. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 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.) | 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 | 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) |
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| 1991-01-01 | Added | First appearance in code book in 1991. |
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