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The procedure described by CPT® Code 21685 refers to a hyoid myotomy and suspension, a surgical intervention primarily aimed at treating obstructive sleep apnea syndrome. This condition is characterized by repeated episodes of airway obstruction during sleep, which can lead to significant health issues. The hyoid myotomy and suspension procedure works by enlarging the airway located behind the tongue, known as the retrolingual space, as well as the lower pharynx, referred to as the hypopharyngeal area. The surgical approach begins with an incision made just above the hyoid bone, allowing the surgeon to create skin flaps that expose the underlying subplatysmal fat and muscles. This exposure is crucial for the subsequent steps of the procedure, which involve partial resection of the subplatysmal fat and careful dissection to access the thyroid cartilage. The technique includes the use of a needle and wire to manipulate the hyoid bone, ultimately advancing it to open the airway and alleviate the obstruction. The procedure concludes with the placement of a drain and closure of the incision layers, ensuring proper healing and recovery.
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The hyoid myotomy and suspension procedure is indicated for patients suffering from obstructive sleep apnea syndrome, particularly when other treatment options have been ineffective. The following conditions may warrant this surgical intervention:
The hyoid myotomy and suspension procedure involves several critical steps to ensure effective treatment of obstructive sleep apnea. The following outlines the procedural steps:
After the hyoid myotomy and suspension procedure, patients can expect a recovery period that may involve monitoring for any complications related to the surgery. Post-operative care typically includes managing pain, ensuring proper wound healing, and monitoring for signs of infection. Patients may also be advised on activity restrictions and follow-up appointments to assess the success of the procedure and the improvement of their obstructive sleep apnea symptoms. It is essential for patients to adhere to their surgeon's post-operative instructions to facilitate optimal recovery.
| Short Descr | HYOID MYOTOMY & SUSPENSION | Medium Descr | HYOID MYOTOMY & SUSPENSION | Long Descr | Hyoid myotomy and suspension | 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 | Device-intensive procedure added to ASC list in CY 2008 or later; paid at adjusted rate. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 164 - Other OR therapeutic procedures on musculoskeletal system |
| 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 | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 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. | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery |
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| 2004-01-01 | Added | First appearance in code book in 2004. |
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