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The CPT® Code 21338 refers to the open treatment of a nasoethmoid fracture without the use of external fixation. This procedure is performed to address fractures located in the nasoethmoid region, which is the area where the nasal bones and the ethmoid bone of the skull meet. The physician employs various surgical incisions to gain access to the fractured bones, allowing for direct visualization and manipulation. Rigid reduction techniques are utilized to stabilize the fractured bones in their correct anatomical position, ensuring proper alignment for optimal healing. To achieve this stabilization, the physician may use various fixation devices such as wires, plates, or screws. In some cases, portions of bone may need to be excised to facilitate the repositioning of the fractured segments. If the medial canthal ligaments, which are important for the structural integrity of the eye and surrounding tissues, are found to be detached during the procedure, they must be reattached. This reattachment is considered a separately reportable service. Once the procedure is completed, all incisions made during the surgery are meticulously closed to promote healing and minimize complications. It is important to code 21338 specifically when external fixation is not required; if external fixation is utilized, the appropriate code would be 21339.
© Copyright 2025 Coding Ahead. All rights reserved.
The open treatment of a nasoethmoid fracture, coded as CPT® 21338, is indicated for patients who have sustained a fracture in the nasoethmoid area. This procedure is typically performed when the fracture is displaced or unstable, necessitating surgical intervention to restore proper alignment and function. The indications for this procedure may include:
The procedure for the open treatment of a nasoethmoid fracture involves several critical steps to ensure successful stabilization of the fractured bones. The steps include:
Following the open treatment of a nasoethmoid fracture, patients can expect a recovery period that may vary depending on the extent of the injury and the surgical intervention performed. Post-procedure care typically includes monitoring for any signs of complications, such as infection or improper healing. Patients may be advised to avoid strenuous activities and follow specific guidelines for wound care to ensure proper healing. Follow-up appointments are essential to assess the healing process and to determine if any additional interventions are necessary. Pain management may also be part of the post-procedure care, with the physician providing recommendations for appropriate pain relief measures.
| Short Descr | OPEN NASOETHMOID FX W/O FIXJ | Medium Descr | OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION | Long Descr | Open treatment of nasoethmoid fracture; without external fixation | 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 | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 144 - Treatment, facial fracture or dislocation |
| 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). | 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. | 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. | 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) |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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