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The CPT® Code 21400 refers to the closed treatment of a fracture of the orbit, specifically excluding blowout fractures. This procedure is characterized by the absence of manipulation, meaning that the fractured bone fragments do not require repositioning. In cases of a nondisplaced fracture of the orbit, the treatment involves a thorough evaluation of the fracture site, which is confirmed through radiographic imaging. The primary goal of this procedure is to ensure that the integrity of the neurovascular structures surrounding the orbit is maintained, which is assessed through a neurovascular examination. This examination checks for any potential damage to the nerves and blood vessels in the area of the injury. Unlike CPT® Code 21401, which involves the manipulation of displaced fracture fragments, CPT® Code 21400 is utilized when the fracture is stable and does not necessitate any corrective measures to restore anatomical alignment. The closed treatment approach is less invasive and focuses on monitoring the healing process without the need for surgical intervention to reposition the bones.
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The closed treatment of a fracture of the orbit, as described by CPT® Code 21400, is indicated for specific conditions related to orbital fractures. These include:
The closed treatment of an orbital fracture involves several key procedural steps, which are outlined as follows:
After the closed treatment of the orbital fracture, the patient is typically monitored for any signs of complications. Follow-up appointments may be scheduled to assess the healing process through additional radiographs if necessary. Patients are advised on post-procedure care, which may include pain management and activity restrictions to prevent further injury. It is important to ensure that the neurovascular integrity remains intact during the recovery period, and any changes in symptoms should be reported to the healthcare provider promptly.
| Short Descr | CLOSED TX ORBIT W/O MANIPULJ | Medium Descr | CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION | Long Descr | Closed treatment of fracture of orbit, except blowout; without manipulation | 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) | 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 | Procedure or Service, Multiple Reduction Applies | 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). | 54 | Surgical care only: when 1 physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding modifier 54 to the usual procedure number. | 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 | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | 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 | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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