How To Use CPT Code 21120

CPT code 21120 describes the procedure for genioplasty augmentation, which involves the use of a chin implant to enhance the appearance of a receding chin. 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 21120?

CPT 21120 is used to describe the procedure for genioplasty augmentation, which involves the placement of a chin implant to improve the cosmetic appearance of a receding chin. This procedure can be performed for both aesthetic reasons and medical necessity, such as correcting bite problems.

2. Official Description

The official description of CPT code 21120 is: ‘Genioplasty augmentation (autograft, allograft, prosthetic material).’ This code encompasses the surgical procedure of enhancing the chin using various materials, including autografts (tissue grafts from the patient’s own body), allografts (tissue grafts from another person), or prosthetic materials like silicone chin implants.

3. Procedure

During a genioplasty augmentation procedure, the patient is appropriately prepped and anesthetized. The provider then makes an incision either under the lower lip inside the mouth or under the chin. The incision is deepened to create a pocket in the tissue. The provider selects the appropriate implant, which can be an autograft, allograft, or prosthetic material like a silicone chin implant. Sizers or trial implants of different sizes may be used to achieve the desired appearance. The implant is placed in the pocket and secured, and the incision is closed with sutures.

4. Qualifying circumstances

Genioplasty augmentation with CPT code 21120 is typically covered by insurance when performed for medically necessary reasons, such as correcting abnormalities that result in significant functional impairment. However, coverage may vary among payers, and it is important to check with the specific insurance company for their guidelines and requirements.

5. When to use CPT code 21120

CPT code 21120 should be used when a provider performs genioplasty augmentation using an autograft, allograft, or prosthetic material. This code is appropriate for both cosmetic and medically necessary procedures. It is important to ensure that the procedure meets the criteria for medical necessity if billing for non-cosmetic reasons.

6. Documentation requirements

To support a claim for CPT code 21120, the provider must document the following information:

• Patient’s diagnosis or indication for the procedure
• Type of implant used (autograft, allograft, or prosthetic material)
• Details of the procedure, including the incision site and technique
• Implant size and selection process
• Any complications or additional procedures performed
• Post-operative care instructions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 21120, it is important to ensure that the procedure meets the criteria for medical necessity if billing for non-cosmetic reasons. Some payers may require prior authorization or additional documentation to support the medical necessity of the procedure. It is also important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT code 21120 was added to the Current Procedural Terminology system on January 1, 1991. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 21120

There are several similar codes to CPT code 21120 that describe other procedures related to repair, revision, and/or reconstruction procedures on the head. Some similar codes include:

• CPT 21121: Genioplasty augmentation; sliding osteotomy, single piece, segmental (eg, horizontal or vertical reduction)
• CPT 21122: Genioplasty augmentation; sliding osteotomies, multiple segment (eg, horizontal and vertical reduction)
• CPT 21123: Genioplasty augmentation; sliding osteotomy, single piece, segmental (eg, horizontal or vertical augmentation)
• CPT 21125: Genioplasty augmentation; sliding osteotomies, multiple segment (eg, horizontal and vertical augmentation)
• CPT 21296: Reconstruction of mandibular rami and/or body with bone graft obtained from the same surgical site (includes obtaining graft)

9. Examples

1. A patient undergoes genioplasty augmentation with a silicone chin implant to improve the appearance of their receding chin.
2. A provider performs genioplasty augmentation using an autograft from the patient’s own body to correct a bite problem.
3. A patient undergoes genioplasty augmentation with an allograft to enhance the cosmetic appearance of their chin.
4. A provider performs genioplasty augmentation using a prosthetic material, such as a silicone chin implant, to improve the patient’s facial symmetry.
5. A patient undergoes genioplasty augmentation with an autograft to correct a congenital chin deformity.
6. A provider performs genioplasty augmentation using an allograft to address functional impairment caused by a receding chin.
7. A patient undergoes genioplasty augmentation with a silicone chin implant to enhance their facial profile.
8. A provider performs genioplasty augmentation using an autograft to improve the patient’s bite alignment.
9. A patient undergoes genioplasty augmentation with an allograft to correct a chin asymmetry.
10. A provider performs genioplasty augmentation using a prosthetic material to address the patient’s dissatisfaction with their chin appearance.