CPT® Code 21340

1. Indications

The procedure described by CPT® Code 21340 is indicated for patients who have sustained a nasoethmoid complex fracture. This type of fracture may occur due to various traumatic events, such as motor vehicle accidents, falls, or physical altercations. The following conditions may warrant the performance of this procedure:

• Nasoethmoid Fracture A fracture involving the nasal and ethmoid bones, which may lead to complications such as misalignment, instability, or damage to surrounding structures.
• Detached Medial Canthal Ligaments Injury to the ligaments that support the inner corner of the eyelids, which may require surgical reattachment to restore normal eyelid function and appearance.
• Compromised Nasolacrimal Apparatus Damage to the tear drainage system that may necessitate surgical repair to prevent issues with tear drainage and maintain ocular health.

2. Procedure

The procedure for CPT® Code 21340 involves several critical steps to ensure effective treatment of the nasoethmoid complex fracture:

• Step 1: Anesthesia Administration The procedure begins with the administration of appropriate anesthesia to ensure patient comfort during the intervention. This may involve local anesthesia or sedation, depending on the complexity of the fracture and the patient's needs.
• Step 2: Percutaneous Access The physician makes small incisions in the skin to access the fracture site percutaneously. This minimally invasive approach helps reduce tissue trauma and promotes quicker recovery.
• Step 3: Stabilization of Fracture Using percutaneous pins or screws, the physician stabilizes the fractured bones by anchoring them to stable bone structures. External fixation devices may also be employed to maintain proper alignment and stability during the healing process.
• Step 4: Repair of Medial Canthal Ligaments If the medial canthal ligaments are found to be detached, the physician carefully reattaches them to restore their function and support for the eyelids.
• Step 5: Repair of Nasolacrimal Apparatus In cases where the nasolacrimal apparatus is compromised, the physician performs a repair using sutures and tubing to ensure proper tear drainage and prevent future complications.
• Step 6: Closure of Incisions After completing the necessary repairs, the physician meticulously closes all incisions to promote healing and minimize scarring. This step is crucial for the overall aesthetic outcome and recovery of the patient.

3. Post-Procedure

Following the procedure coded as CPT® 21340, patients can expect specific post-operative care and considerations. It is essential to monitor for any signs of complications, such as infection or improper healing. Patients may be advised to avoid strenuous activities and follow specific guidelines regarding wound care to ensure optimal recovery. Follow-up appointments will be necessary to assess healing progress and the integrity of the repairs made during the procedure. The physician may also provide instructions on managing pain and any prescribed medications to aid in recovery.