How To Use CPT Code 21047

CPT code 21047 describes the excision of a benign tumor or cyst of the mandible that requires an extra-oral osteotomy and partial mandibulectomy. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 21047?

CPT 21047 is used to describe the excision of a benign tumor or cyst of the mandible that requires an extra-oral osteotomy and partial mandibulectomy. This code is used when a healthcare provider removes a noncancerous mass from the lower jaw bone, such as a tumor or cyst, that is locally aggressive or destructive in nature.

2. Official Description

The official description of CPT code 21047 is: ‘Excision of benign tumor or cyst of mandible requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s]).’

3. Procedure

The procedure for CPT code 21047 involves the excision of a benign tumor or cyst of the mandible that requires an extra-oral osteotomy and partial mandibulectomy. The healthcare provider begins by making an incision in the skin over the mass and extends it down to the bone. The tumor is marked along with the appropriate surgical margin, and the provider uses a bone drill or osteotome to remove the mass and the surrounding tissue. If necessary, the associated part of the mandibular bone is also excised to ensure complete removal of the tumor. Bone grafting and flap reconstruction may be performed to fill in any defects. The area is then irrigated, checked for bleeding, and closed with sutures.

4. Qualifying circumstances

CPT 21047 is used for patients who have a benign tumor or cyst of the mandible that requires excision and partial removal of the lower jaw bone. The mass must be locally aggressive or destructive in nature. The procedure is performed using an extra-oral osteotomy, which means accessing the jaw through an incision in the skin of the face or neck.

5. When to use CPT code 21047

CPT code 21047 should be used when a healthcare provider performs the excision of a benign tumor or cyst of the mandible that requires an extra-oral osteotomy and partial mandibulectomy. This code is appropriate when the tumor or cyst is locally aggressive or destructive in nature and the procedure involves removing a portion of the lower jaw bone.

6. Documentation requirements

To support a claim for CPT 21047, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for excision of the benign tumor or cyst
• Description of the tumor or cyst and its characteristics
• Date of the procedure
• Details of the surgical approach, including the extra-oral osteotomy
• Extent of the excision and any associated bone removal
• Use of bone grafting or flap reconstruction, if applicable
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 21047, ensure that the excision of the benign tumor or cyst of the mandible requires an extra-oral osteotomy and partial mandibulectomy. This code should not be reported with other codes for excision procedures on the head. If a bone graft is harvested for reconstruction of the mandible, it should be reported separately.

8. Historical information

CPT 21047 was added to the Current Procedural Terminology system on January 1, 2003. There have been no updates to the code since its addition.

9. Similar codes to CPT 21047

Five similar codes to CPT 21047 include:

• CPT 21048: Excision of benign tumor or cyst of mandible requiring intraoral osteotomy and partial mandibulectomy
• CPT 21049: Excision of benign tumor or cyst of mandible requiring intraoral osteotomy and complete mandibulectomy
• CPT 21050: Excision of benign tumor or cyst of mandible requiring extraoral osteotomy and complete mandibulectomy
• CPT 21051: Excision of benign tumor or cyst of mandible requiring intraoral osteotomy and segmental mandibulectomy
• CPT 21052: Excision of benign tumor or cyst of mandible requiring extraoral osteotomy and segmental mandibulectomy

9. Examples

1. A healthcare provider performs the excision of a benign tumor of the mandible that requires an extra-oral osteotomy and partial mandibulectomy.
2. A patient presents with a locally aggressive cyst of the mandible, and a healthcare provider performs the excision using an extra-oral osteotomy and partial mandibulectomy.
3. A healthcare provider removes a destructive tumor of the mandible through an extra-oral osteotomy and partial mandibulectomy.
4. A patient undergoes the excision of a benign tumor of the mandible that requires an extra-oral osteotomy and partial mandibulectomy due to its aggressive growth.
5. A healthcare provider performs the excision of a locally aggressive cyst of the mandible using an extra-oral osteotomy and partial mandibulectomy.
6. A patient with a destructive tumor of the mandible undergoes the excision procedure, which involves an extra-oral osteotomy and partial mandibulectomy.
7. A healthcare provider removes a benign tumor of the mandible that requires an extra-oral osteotomy and partial mandibulectomy due to its locally aggressive nature.
8. A patient presents with a locally destructive cyst of the mandible, and a healthcare provider performs the excision using an extra-oral osteotomy and partial mandibulectomy.
9. A healthcare provider performs the excision of a benign tumor of the mandible that requires an extra-oral osteotomy and partial mandibulectomy to prevent further destruction.
10. A patient undergoes the excision of a locally aggressive cyst of the mandible using an extra-oral osteotomy and partial mandibulectomy.