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The procedure described by CPT® Code 21208 involves osteoplasty of the facial bones, specifically focusing on augmentation techniques. Osteoplasty refers to the surgical modification or reconstruction of bone, and in this context, it is aimed at enhancing the structure and contour of the facial bones. The augmentation can be achieved through various means, including the use of autografts, which are bone grafts harvested from the patient's own body, such as the hip, skull, or rib. Alternatively, allografts, which are bone grafts obtained from a donor, or prosthetic implants, which are artificial devices designed to replace or support the bone structure, may be utilized. The procedure typically begins with the physician making an incision over the targeted bone area to access the site for grafting or implanting. After the grafts or prosthetic materials are inserted to achieve the desired contour, the incisions are meticulously closed to promote healing. This surgical intervention is often indicated for patients seeking to correct facial deformities, enhance aesthetic appearance, or restore function following trauma or congenital conditions.
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The procedure described by CPT® Code 21208 is indicated for various conditions and circumstances that necessitate augmentation of the facial bones. These indications may include:
The osteoplasty procedure for facial bone augmentation involves several critical steps to ensure successful outcomes. The first step is the careful planning and assessment of the patient's facial structure, which helps the physician determine the appropriate grafting material and surgical approach. Following this, the physician administers anesthesia to ensure the patient is comfortable and pain-free during the procedure. Once the patient is adequately prepared, the physician makes a precise incision over the area of the facial bone that requires augmentation. This incision allows access to the underlying bone structure.
Next, the physician selects the grafting material, which may be an autograft harvested from the patient's own body, an allograft from a donor, or a prosthetic implant. If an autograft is chosen, the physician will perform an additional procedure to harvest the bone from the designated site, such as the hip, skull, or rib. After obtaining the graft, the physician carefully shapes and prepares it for insertion. The graft or prosthetic is then placed into the prepared site on the facial bone, ensuring it is positioned correctly to achieve the desired contour and support.
Once the graft or implant is securely in place, the physician meticulously closes the incision using sutures or other closure techniques to promote optimal healing. The entire procedure is conducted with precision to minimize complications and ensure the best possible aesthetic and functional results for the patient.
After the completion of the osteoplasty procedure, patients are typically monitored in a recovery area to ensure they are stable and comfortable. Post-procedure care may include pain management strategies, such as prescribed medications, to alleviate discomfort. Patients are advised to follow specific instructions regarding activity restrictions, wound care, and signs of potential complications, such as infection or excessive swelling. Follow-up appointments are essential to assess healing progress and the success of the augmentation. The expected recovery time may vary depending on the extent of the procedure and the individual patient's healing response, but patients are generally encouraged to avoid strenuous activities for a specified period to facilitate optimal recovery.
| Short Descr | AUGMENTATION OF FACIAL BONES | Medium Descr | OSTEOPLASTY FACIAL BONES AUGMENTATION | Long Descr | Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant) | 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 | 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 |
| 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. | 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) | 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. | 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.) | 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). | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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