How To Use CPT Code 21208

CPT code 21208 describes a surgical procedure called osteoplasty, which involves the repair and alteration of facial bones. 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 21208?

CPT 21208 is used to describe a surgical procedure known as osteoplasty. This procedure involves the augmentation or building up of facial bones using an implant made from artificial material or bone graft taken from the patient or a donor. The purpose of osteoplasty is to correct defects caused by trauma or malformation in the facial bones.

2. Official Description

The official description of CPT code 21208 is: ‘Osteoplasty, facial bones augmentation (autograft, allograft, or prosthetic implant).’ This code encompasses the surgical repair and alteration of facial bones using various augmentation techniques.

3. Procedure

During the osteoplasty procedure, the healthcare provider begins by preparing and anesthetizing the patient. They then determine the source of the implant, which can be either autograft (harvested from the patient’s own body) or allograft (obtained from a donor). If autograft is chosen, the provider makes an incision over the donor site, typically the hip bone, and removes the necessary amount of bone material. The incision is then closed.

Next, the provider makes an incision in the facial skin over the bone that requires augmentation. Using microsurgical techniques, they carefully dissect the bone away from the surrounding tissues. The implant material, whether it is artificial or the autograft/allograft, is then inserted and positioned to achieve the desired appearance. The provider ensures proper irrigation, checks for bleeding, and closes the incision.

4. Qualifying circumstances

Osteoplasty with CPT code 21208 is performed on patients who have facial bone defects resulting from trauma or malformation. The procedure is intended to correct these defects and improve the patient’s facial appearance and function. The choice of using autograft, allograft, or a prosthetic implant depends on the specific circumstances and the provider’s judgment.

5. When to use CPT code 21208

CPT code 21208 should be used when a healthcare provider performs osteoplasty to augment facial bones using autograft, allograft, or a prosthetic implant. This code is appropriate for cases where the patient has facial bone defects that require surgical correction. It is important to accurately document the specific procedure performed and the materials used to support the use of this code.

6. Documentation requirements

When reporting CPT code 21208, the healthcare provider must ensure proper documentation of the following:

• Patient’s diagnosis indicating the need for osteoplasty
• Source of the implant (autograft, allograft, or prosthetic implant)
• Date of the procedure
• Details of the surgical technique used
• Specific bones augmented
• Any complications encountered during the procedure
• Post-operative care instructions
• Signature of the performing healthcare provider

7. Billing guidelines

When billing for CPT code 21208, it is important to ensure that the procedure performed aligns with the description of osteoplasty for facial bone augmentation. The provider should use the appropriate modifier if necessary and follow any specific billing guidelines provided by the payer. It is also important to review any bundling or unbundling rules that may apply to this code.

8. Historical information

CPT code 21208 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 21208

There are several similar codes to CPT 21208 that describe other repair, revision, and reconstruction procedures on the head. Some examples include:

• CPT 21120: Reconstruction midface, Le Fort I
• CPT 21121: Reconstruction midface, Le Fort II
• CPT 21122: Reconstruction midface, Le Fort III
• CPT 21123: Reconstruction midface, Le Fort I and II
• CPT 21206: Osteotomy, facial bones; other than Le Fort type

9. Examples

1. A patient undergoes osteoplasty with CPT code 21208 to correct facial bone defects resulting from a car accident.
2. A healthcare provider performs osteoplasty using autograft material to augment the facial bones of a patient with a congenital malformation.
3. A prosthetic implant is used during osteoplasty with CPT code 21208 to enhance the appearance of a patient’s facial bones.
4. A patient undergoes osteoplasty to correct facial bone defects caused by a previous surgical procedure.
5. A healthcare provider performs osteoplasty using allograft material to reconstruct the facial bones of a patient with a history of trauma.
6. Osteoplasty is performed on a patient to improve facial symmetry and restore normal facial contours.
7. A patient undergoes osteoplasty to correct facial bone defects resulting from a sports injury.
8. A healthcare provider performs osteoplasty using autograft material harvested from the patient’s own body to augment the facial bones.
9. Osteoplasty is performed on a patient to correct facial bone defects caused by a congenital condition.
10. A prosthetic implant is used during osteoplasty to restore facial bone structure and improve the patient’s appearance.