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A Le Fort III fracture, commonly referred to as a craniofacial separation or dysjunction, represents a significant injury characterized by a transverse fracture of the midface. This type of fracture initiates at the nasofrontal and frontomaxillary sutures, extending posteriorly along the medial wall of the orbit. The fracture path traverses through the nasolacrimal groove and the ethmoid bones, continuing along the floor of the orbit at the inferior orbital fissure. It further extends through the lateral orbital wall, the zygomaticofrontal junction, and the zygomatic arch. Additionally, a branch of the fracture may extend through the base of the perpendicular plate of the ethmoid and the vomer, as well as the interface of the pterygoid plates leading to the base of the sphenoid. The treatment for this type of fracture can vary; for instance, CPT® Code 21431 involves a closed reduction, where disimpaction of the maxillary bone is achieved using specialized instruments. In contrast, CPT® Code 21432 pertains to the open treatment of the craniofacial separation, which involves surgical intervention through an incision made intraorally in the buccal sulcus, or alternatively through subciliary or transconjunctival incisions. This procedure allows for direct access to the fracture site, enabling the surgeon to perform an open reduction and stabilize the fracture using wiring and/or internal fixation methods, such as miniplates and monocortical self-tapping screws, ensuring proper anatomical alignment and stabilization of the fractured segments.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 21432 is indicated for the treatment of a Le Fort III fracture, which is a severe craniofacial injury. The specific indications for performing this open treatment include:
The open treatment of a Le Fort III fracture as described in CPT® Code 21432 involves several critical procedural steps:
Post-procedure care following the open treatment of a Le Fort III fracture includes monitoring for complications, managing pain, and ensuring proper healing of the surgical site. Patients may be advised to follow a soft diet to minimize stress on the surgical area. Follow-up appointments are essential to assess the healing process and to remove any sutures if necessary. Additionally, patients should be educated on signs of infection or complications that may require immediate medical attention. The expected recovery time can vary based on the extent of the injury and the individual patient's healing response.
| Short Descr | OPTX CRANFCL SEP W/WIRING | Medium Descr | OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ | Long Descr | Open treatment of craniofacial separation (LeFort III type); with wiring and/or internal 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) | 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 | Inpatient Procedures, not paid under OPPS | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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