How To Use CPT Code 21150

CPT code 21150 describes a reconstructive procedure known as LeFort II anterior intrusion. This article will provide a comprehensive overview of CPT code 21150, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when to use CPT code 21150.

1. What is CPT Code 21150?

CPT code 21150 is used to describe a specific reconstructive procedure called LeFort II anterior intrusion. This procedure involves the reconstruction of the midface bones to correct deformities, whether they are acquired or congenital, such as Treacher Collins syndrome. The purpose of this surgery is to restore the normal appearance and function of the facial structures.

2. Official Description

The official description of CPT code 21150 is: ‘Reconstruction midface, LeFort II anterior intrusion (e.g., Treacher-Collins Syndrome).’ This code specifically refers to the surgical procedure that involves the repositioning of the facial bones in the midface region to correct deformities.

3. Procedure

During a LeFort II anterior intrusion procedure, the patient is appropriately prepped and anesthetized. The surgeon makes incisions in the mouth, behind the lower eyelids, and/or through the skin below the lower eyelids. The nose is incised using a bicoronal approach, and the scalp is raised forward to gain access to the nasal bones. The surgeon then repositions the bones in a predetermined fashion until the desired appearance is achieved. Suction drains may be placed in the scalp to reduce bruising. Finally, the incisions are closed with layered sutures.

4. Qualifying circumstances

CPT code 21150 is used for patients who require reconstructive surgery of the midface due to deformities, whether they are congenital or acquired. One example of such a condition is Treacher Collins syndrome, a rare genetic disorder that results in severe congenital malformation of the facial structures. This procedure is typically performed by a qualified surgeon who specializes in craniofacial surgery.

5. When to use CPT code 21150

CPT code 21150 should be used when a patient requires a LeFort II anterior intrusion procedure to correct midface deformities. It is important to note that this code should only be used for medically necessary reasons and not for cosmetic purposes. Preauthorization is often recommended to ensure coverage for this procedure.

6. Documentation requirements

To support a claim for CPT code 21150, the surgeon must document the following information:

• Patient’s diagnosis and the need for midface reconstruction
• Details of the procedure performed, including the specific techniques used
• Date of the surgery
• Any complications or unexpected findings during the procedure
• Post-operative care instructions
• Signature of the surgeon performing the procedure

7. Billing guidelines

When billing for CPT code 21150, it is important to ensure that the procedure meets the criteria for medical necessity. Preauthorization is often recommended to avoid potential denials. This code should not be reported with other codes unless there are additional procedures performed during the same surgical session that warrant separate reporting.

8. Historical information

CPT code 21150 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 21150

While there are no specific similar codes to CPT code 21150, there are other LeFort osteotomy codes that may be used for different types of midface reconstruction procedures. These include:

• CPT 21120: Reconstruction midface, LeFort I
• CPT 21200: Reconstruction midface, LeFort III
• CPT 21206: Reconstruction midface, LeFort III with facial cleft
• CPT 21208: Reconstruction midface, LeFort III with facial cleft and orbital deformity
• CPT 21210: Reconstruction midface, LeFort III with facial cleft and orbital deformity, with bone graft

9. Examples

1. A patient with Treacher Collins syndrome undergoing a LeFort II anterior intrusion procedure to correct midface deformities.
2. A patient with a traumatic injury to the midface requiring a LeFort II anterior intrusion procedure for reconstruction.
3. A patient with a congenital midface deformity undergoing a LeFort II anterior intrusion procedure to improve facial appearance and function.
4. A patient with a history of failed previous midface reconstruction undergoing a LeFort II anterior intrusion procedure for revision.
5. A patient with a severe midface deformity due to a genetic disorder requiring a LeFort II anterior intrusion procedure for functional and aesthetic improvement.
6. A patient with a midface deformity resulting from a tumor resection undergoing a LeFort II anterior intrusion procedure for reconstruction.
7. A patient with a midface deformity due to a developmental anomaly undergoing a LeFort II anterior intrusion procedure to correct the facial structure.
8. A patient with a midface deformity resulting from a previous surgery undergoing a LeFort II anterior intrusion procedure for revision and improvement.
9. A patient with a congenital midface deformity requiring a LeFort II anterior intrusion procedure to improve breathing and facial symmetry.
10. A patient with a midface deformity due to a congenital syndrome undergoing a LeFort II anterior intrusion procedure for functional and aesthetic correction.