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The procedure described by CPT® Code 21245 involves the reconstruction of the mandible or maxilla using a subperiosteal implant, specifically for partial reconstruction. This surgical intervention is indicated for patients who have lost teeth and require structural support for dental prosthetics. The process begins with the physician making an incision in the area of the jaw where teeth are absent, allowing for direct access to the underlying bone. The bone is then carefully exposed to the greatest extent possible to facilitate the insertion of a custom-made implant. This implant is typically crafted from metal and features posts that are essential for the fixation of dental devices. The procedure can be performed in one or two surgical sessions, depending on the technique used for creating the implant. In cases where the implant is made from molds taken during a previous visit, two sessions may be necessary. Alternatively, if CT scans of the jaw are utilized to design the implant, the entire procedure can often be completed in a single session. After the implant is placed, the surrounding tissue is meticulously arranged and sutured around the posts, ensuring that the metal plate is properly positioned against the bone. The fixation of the implant is achieved through the natural healing and scarring processes of the body. Finally, all incisions are closed to promote recovery. It is important to note that CPT® Code 21245 is specifically for partial reconstructions, while CPT® Code 21246 is designated for complete reconstructions.
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The procedure associated with CPT® Code 21245 is indicated for patients who have experienced partial loss of teeth and require a supportive structure for dental prosthetics. The following conditions may warrant this surgical intervention:
The procedure for CPT® Code 21245 involves several critical steps to ensure the successful placement of a subperiosteal implant for partial reconstruction of the mandible or maxilla. The following steps outline the process:
After the completion of the procedure associated with CPT® Code 21245, patients can expect a recovery period that may vary based on individual circumstances. Post-procedure care typically includes monitoring for any signs of infection, managing pain with prescribed medications, and following specific instructions provided by the surgeon. Patients are advised to avoid strenuous activities and adhere to a soft diet to minimize stress on the surgical site. Follow-up appointments will be necessary to assess healing and determine the appropriate timing for the placement of dental prosthetics on the newly installed implant. It is essential for patients to maintain good oral hygiene and attend all scheduled follow-ups to ensure the success of the implant and overall oral health.
| Short Descr | RECONSTRUCTION OF JAW | Medium Descr | RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL | Long Descr | Reconstruction of mandible or maxilla, subperiosteal implant; partial | 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). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 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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| Pre-1990 | Added | Code added. |
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