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The procedure described by CPT® Code 21255 involves the reconstruction of the zygomatic arch and glenoid fossa using bone and cartilage grafts, which may be harvested from the patient's own body, known as autografts. This surgical intervention is typically indicated for patients who have suffered trauma or have congenital deformities affecting the zygomatic arch, which is the bone that forms the prominence of the cheek, and the glenoid fossa, the socket in the temporal bone that receives the head of the mandible. The procedure aims to restore the structural integrity and function of these facial components, which are crucial for both aesthetic appearance and proper jaw function. The surgical technique includes making an incision near the ear to access the affected area, followed by the careful resection of tissue to expose the zygomatic arch and glenoid fossa. The harvested graft, often taken from the rib, is then meticulously placed into the prepared recipient bed, and secured using various fixation methods such as wires, plates, or screws. Finally, the incisions are closed to promote healing and minimize scarring.
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The procedure described by CPT® Code 21255 is indicated for the following conditions:
The procedure for CPT® Code 21255 involves several critical steps to ensure successful reconstruction of the zygomatic arch and glenoid fossa:
Post-procedure care for patients undergoing reconstruction of the zygomatic arch and glenoid fossa includes monitoring for any signs of complications such as infection or graft failure. Patients are typically advised to follow specific guidelines regarding activity restrictions to ensure proper healing. Pain management may be necessary, and follow-up appointments are essential to assess the integration of the graft and the overall recovery process. The expected recovery time can vary based on individual circumstances, but patients should be prepared for a period of healing during which swelling and discomfort may occur.
| Short Descr | RECONSTRUCT LOWER JAW BONE | Medium Descr | RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG | Long Descr | Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts) | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | 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). | 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 1991-01-01 | Added | First appearance in code book in 1991. |
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