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The procedure described by CPT® Code 21347 involves the open treatment of a nasomaxillary complex fracture, specifically classified as a LeFort II type fracture. This type of fracture is often referred to as a pyramidal fracture due to its characteristic shape. In this surgical intervention, the physician performs the repair in an open environment, which allows for direct visualization and access to the fractured area. The procedure necessitates multiple incisions to adequately access the fracture site, enabling the physician to manipulate and realign the fractured bones to their proper anatomical position. To ensure stability at the fracture site, the physician employs various fixation devices, including screws, wires, and/or plates. After the fracture has been stabilized, all incisions made during the procedure are meticulously closed. In some cases, intermaxillary fixation may be required to maintain the alignment of the jaw during the healing process. This comprehensive approach is essential for restoring function and aesthetics in patients with complex nasomaxillary injuries.
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The open treatment of a nasomaxillary complex fracture (LeFort II type) is indicated in the following scenarios:
The procedure for the open treatment of a nasomaxillary complex fracture (LeFort II type) involves several critical steps:
After the completion of the procedure, the patient is monitored in a recovery area until the effects of anesthesia wear off. Post-operative care includes managing pain and preventing infection at the incision sites. The patient may be advised to follow a soft diet and avoid strenuous activities to facilitate healing. Follow-up appointments are essential to assess the healing process and to remove any sutures if necessary. The physician may also provide specific instructions regarding oral hygiene and care for the surgical sites to ensure optimal recovery.
| Short Descr | OPN TX NASOMAX FX MULTPLE | Medium Descr | OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN | Long Descr | Open treatment of nasomaxillary complex fracture (LeFort II type); requiring multiple open approaches | 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 | 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. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | 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) | RT | Right side (used to identify procedures performed on the right side of the body) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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