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The procedure described by CPT® Code 21268 involves the surgical repositioning of one orbit through periorbital osteotomies, utilizing bone grafts and employing a combined intra- and extracranial approach. This complex surgical intervention is performed to correct orbital deformities or displacements. The term "periorbital osteotomies" refers to the surgical cutting of the bone surrounding the orbit, which is the bony cavity that houses the eye. The procedure necessitates the temporary removal of a portion of the frontal bone to allow access for intracranial cuts, which are essential for the repositioning of the orbit. During this phase, the brain is carefully retracted to provide the necessary space for the surgeon to work. Bone grafts, which may be harvested from the patient's hip, rib, or skull, are utilized to fill any defects created during the repositioning process. The surgeon can access the orbit through various incision points, including the lower eyelid, eyebrow, or maxillary vestibule, depending on the specific requirements of the case. Once access to the orbit is achieved, specialized instruments such as drills and saws are employed to create precise incisions in the orbital rim. After repositioning the orbit, it is secured in place using wires, screws, and plates to ensure stability. The harvested grafts are then placed into the recipient beds to address the defects resulting from the surgical adjustments. Finally, the frontal bone is reattached using plates or screws, allowing the brain to return to its original position, and all incisions are meticulously closed to promote healing.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 21268 is indicated for various conditions that necessitate the repositioning of the orbit. These may include:
The procedure involves several critical steps to ensure successful orbital repositioning:
Post-procedure care following CPT® Code 21268 involves monitoring the patient for any complications and ensuring proper healing of the surgical site. Patients may experience swelling and discomfort, which can be managed with appropriate pain relief measures. Follow-up appointments are essential to assess the positioning of the orbit and the integration of the bone grafts. The healthcare team will provide specific instructions regarding activity restrictions and signs of potential complications that should prompt immediate medical attention. Overall, the recovery process will vary based on individual patient factors and the extent of the surgical intervention.
| Short Descr | REVISE EYE SOCKETS | Medium Descr | ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC | Long Descr | Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach | 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 | Inpatient Procedures, not paid under OPPS | 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). | 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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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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