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The CPT® Code 21339 refers to the open treatment of a nasoethmoid fracture, specifically when external fixation is utilized. This procedure involves a surgical approach where the physician makes various incisions to gain access to the fractured bones in the nasoethmoid region, which is located between the nose and the ethmoid bone of the skull. The primary goal of this treatment is to achieve rigid reduction, a technique that stabilizes the fractured bones in their correct anatomical position. To ensure proper alignment and stabilization, the physician may employ various fixation devices such as wires, plates, or screws. In some cases, portions of the fractured bone may need to be excised to facilitate the repositioning of the bones. Additionally, 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 note that if external fixation is not required, the appropriate code to use would be CPT® Code 21338.
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The open treatment of a nasoethmoid fracture with external fixation, represented by CPT® Code 21339, is indicated for patients who have sustained a fracture in the nasoethmoid area. This procedure is typically performed when there is a need for surgical intervention to realign and stabilize the fractured bones due to significant displacement or instability. The indications for this procedure may include:
The procedure for the open treatment of a nasoethmoid fracture with external fixation involves several critical steps to ensure successful stabilization of the fractured bones. The steps include:
After the open treatment of a nasoethmoid fracture with external fixation, patients typically require careful monitoring and follow-up care. Post-procedure care may include pain management, instructions for wound care, and guidance on activity restrictions to promote healing. Patients may also need to attend follow-up appointments to assess the healing process and ensure that the bones remain properly aligned. The expected recovery time can vary based on the severity of the fracture and the individual patient's healing response. It is important for patients to adhere to their healthcare provider's recommendations to optimize recovery and minimize complications.
| Short Descr | OPEN NASOETHMOID FX W/ FIXJ | Medium Descr | OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION | Long Descr | Open treatment of nasoethmoid fracture; with 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) | 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 | 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) | P3D - Major procedure, orthopedic - other | 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. | 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.) | 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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