CPT® Code 21195

1. Indications

The procedure coded as CPT® 21195 is indicated for various conditions affecting the mandible, particularly when surgical intervention is necessary to correct skeletal discrepancies or malocclusions. The following are specific indications for performing this procedure:

• Jaw Deformities Conditions such as prognathism or retrognathism, where the jaw is positioned too far forward or backward, necessitating surgical correction.
• Malocclusion Severe misalignment of the teeth and jaws that cannot be adequately addressed through orthodontic treatment alone.
• Trauma Injuries to the mandible that result in fractures or dislocations requiring surgical reconstruction to restore function and aesthetics.
• Congenital Anomalies Birth defects affecting the structure of the jaw that may require surgical intervention for proper function and appearance.

2. Procedure

The surgical procedure for CPT® Code 21195 involves several critical steps to ensure successful reconstruction of the mandibular rami and/or body:

• Step 1: Anesthesia Administration The procedure begins with the administration of appropriate anesthesia to ensure the patient is comfortable and pain-free throughout the surgery. This may involve general anesthesia or local anesthesia with sedation, depending on the complexity of the case and the patient's needs.
• Step 2: Incision Creation The surgeon makes a precise incision over the mandibular ramus, which is the vertical part of the mandible. This incision provides direct access to the bone and is carefully planned to minimize scarring and facilitate healing.
• Step 3: Mandibular Separation Using specialized surgical instruments such as saws, drills, and osteotomes, the surgeon carefully separates the mandible along a predetermined line. This step is crucial for allowing the jaw to be repositioned effectively.
• Step 4: Repositioning the Mandible Once the mandible is split, the surgeon moves the jaw forward into the desired position. This adjustment is made based on the specific anatomical and functional requirements of the patient, aiming to achieve optimal alignment and occlusion.
• Step 5: Stabilization After repositioning, the mandible is held in place using wires. This method of stabilization is essential for maintaining the new position during the healing process.
• Step 6: Closure of Incisions Finally, the surgeon carefully closes the incisions made during the procedure. This step is performed using sutures or other closure techniques to ensure proper healing and minimize the risk of infection.

3. Post-Procedure

After the completion of the procedure coded as CPT® 21195, patients typically require post-operative care to ensure proper healing and recovery. This may include pain management strategies, dietary modifications to accommodate the healing jaw, and instructions for oral hygiene to prevent infection. Patients are often advised to follow up with their healthcare provider to monitor the healing process and assess the stability of the mandible. Recovery time can vary based on individual factors, but patients should expect some swelling and discomfort in the initial days following surgery. Adhering to the post-operative care plan is crucial for achieving the best possible outcomes from the procedure.