How To Use CPT Code 21210

CPT code 21210 describes the application of bone graft material to correct cosmetic deformities of the bony structures of the nose, upper jaw, and cheeks caused by injury or disease. 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 21210?

CPT 21210 is used to describe the application of bone graft material to correct cosmetic deformities of the bony structures of the nose, upper jaw, and cheeks. This procedure is typically performed by a healthcare provider to address issues caused by injury or disease.

2. Official Description

The official description of CPT code 21210 is: ‘Graft, bone nasal, maxillary or malar areas (includes obtaining graft).’ This code is used when the provider applies bone graft material to the face to correct cosmetic deformities of the bony structures of the nose, upper jaw, and cheeks.

3. Procedure

During the procedure for CPT 21210, the patient is appropriately prepped and anesthetized. The provider makes an incision over the chosen site for harvesting a bone graft, which is typically the hip bone. The provider then removes sufficient autograft material or may use donor bone for the procedure. The face is incised over the site of the defect, and the graft is positioned at the site of repair, either superficially, just below the skin, or deep to the nasal bone. The graft is fixed in place using screws, plates, or wires, and the wound is closed with layered sutures.

4. Qualifying circumstances

CPT 21210 is performed to correct cosmetic deformities of the bony structures of the nose, upper jaw, and cheeks caused by injury or disease. The procedure involves the application of bone graft material to address these deformities. It is important to note that CPT 21210 should not be reported for cleft palate repair, as there are specific codes (42200-42225) for that procedure.

5. When to use CPT code 21210

CPT code 21210 should be used when a healthcare provider applies bone graft material to correct cosmetic deformities of the bony structures of the nose, upper jaw, and cheeks. It is important to ensure that the procedure is performed for the intended purpose and that the documentation supports the use of this code.

6. Documentation requirements

To support a claim for CPT 21210, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for correction of cosmetic deformities
• Details of the bone graft material used (autograft or donor bone)
• Location of the incision and site of the defect
• Method of fixation for the graft (screws, plates, wires)
• Details of wound closure

7. Billing guidelines

When billing for CPT 21210, ensure that the procedure involves the application of bone graft material to correct cosmetic deformities of the bony structures of the nose, upper jaw, and cheeks. It is important to follow the specific guidelines provided by the payer and use the appropriate modifiers if necessary.

8. Historical information

CPT 21210 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 21210

There are several similar codes to CPT 21210 that are used for different procedures. These include:

• CPT 21120: Reconstruction of the forehead
• CPT 21121: Reconstruction of the forehead and brow
• CPT 21122: Reconstruction of the forehead, brow, and upper eyelid
• CPT 21123: Reconstruction of the forehead, brow, upper eyelid, and cheek
• CPT 21296: Reconstruction of the mandible

9. Examples

1. A patient undergoes CPT 21210 to correct a nasal deformity caused by a previous injury.
2. A healthcare provider performs CPT 21210 to address cosmetic deformities of the upper jaw resulting from a congenital condition.
3. A patient undergoes CPT 21210 to correct cheek asymmetry caused by a disease-related bone loss.
4. A healthcare provider applies bone graft material using CPT 21210 to address cosmetic deformities of the nose caused by trauma.
5. A patient undergoes CPT 21210 to correct bony defects in the maxillary area resulting from a previous surgery.
6. A healthcare provider performs CPT 21210 to address cosmetic deformities of the malar area caused by a congenital condition.
7. A patient undergoes CPT 21210 to correct nasal bone deformities resulting from a disease-related condition.
8. A healthcare provider applies bone graft material using CPT 21210 to address cosmetic deformities of the upper jaw caused by trauma.
9. A patient undergoes CPT 21210 to correct cheekbone asymmetry resulting from a previous surgery.
10. A healthcare provider performs CPT 21210 to address cosmetic deformities of the maxillary area caused by a congenital condition.