How To Use CPT Code 21244

CPT code 21244 describes the reconstruction of the mandible, or lower jaw, using a transosteal bone plate, such as a mandibular staple bone plate. 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 21244?

CPT 21244 is used to describe the reconstruction of the mandible, specifically the lower jaw, using a transosteal bone plate. This procedure is performed to repair defects in the jaw that hinder its normal function. The provider applies a metal plate that extends through the jaw bone, securing it with pins inserted through the bone and into the gums. This helps to stabilize the jaw and restore its proper structure.

2. Official Description

The official description of CPT code 21244 is: ‘Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate).’ This code specifically refers to the use of a transosteal bone plate, such as a mandibular staple bone plate, for the reconstruction of the mandible.

3. Procedure

During the procedure for CPT 21244, the provider begins by making an incision in the skin over the mandible, or lower jaw, and extends the incision down to the bone. Using a trocar, the provider inserts metal pins through the mandible. A mandibular staple bone plate is then attached to the pins, securing it to the jaw bone. The area is irrigated, checked for bleeding, and any instruments are removed. Finally, the incision is closed.

4. Qualifying circumstances

CPT 21244 is performed on patients who require reconstruction of the mandible due to defects that affect the normal function of the jaw. This procedure is typically used to address medical conditions rather than cosmetic purposes. It is important to obtain preauthorization from the insurer to ensure that the procedure is recognized as medically necessary.

5. When to use CPT code 21244

CPT code 21244 should be used when the provider performs the reconstruction of the mandible using a transosteal bone plate, such as a mandibular staple bone plate. This code is specific to the extraoral approach and the use of a transosteal bone plate. If a different approach or type of bone plate is used, a different CPT code may be more appropriate.

6. Documentation requirements

To support a claim for CPT 21244, the provider must document the following information:

• Patient’s diagnosis and the need for mandible reconstruction
• Details of the procedure, including the use of a transosteal bone plate
• Date of the procedure
• Start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 21244, ensure that the procedure meets the criteria for reconstruction of the mandible using a transosteal bone plate. It is important to obtain preauthorization from the insurer to ensure coverage for the procedure. Additionally, be aware that some insurers may flag CPT 21244 as a cosmetic procedure, so it is important to clearly document the medical necessity of the reconstruction.

8. Historical information

CPT 21244 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 21244

There are several similar codes to CPT 21244 that describe other repair, revision, and reconstruction procedures on the head. These include:

• CPT 21120: Reconstruction of mandible, intraoral (eg, using rib graft)
• CPT 21121: Reconstruction of mandible, extraoral (eg, using microvascular techniques)
• CPT 21122: Reconstruction of mandible, extraoral (eg, using microvascular techniques), with bone graft (includes obtaining graft)
• CPT 21210: Reconstruction of mandible, intraoral (eg, using distraction osteogenesis)
• CPT 21215: Reconstruction of mandible, extraoral (eg, using distraction osteogenesis)

9. Examples

1. A patient with a severe mandibular defect undergoes reconstruction using a transosteal bone plate to restore proper jaw function.
2. A trauma patient with a fractured mandible undergoes reconstruction using a mandibular staple bone plate to stabilize the jaw and promote healing.
3. A patient with a congenital jaw deformity undergoes reconstruction using a transosteal bone plate to correct the structural abnormality.
4. A patient with a tumor in the mandible undergoes reconstruction using a mandibular staple bone plate after tumor removal to restore jaw function.
5. A patient with a history of failed previous mandible reconstruction undergoes revision surgery using a transosteal bone plate to address complications and improve jaw function.
6. A patient with a mandibular defect resulting from a previous surgical procedure undergoes reconstruction using a mandibular staple bone plate to restore proper jaw structure.
7. A patient with a mandibular defect due to infection undergoes reconstruction using a transosteal bone plate to repair the jaw and prevent further complications.
8. A patient with a mandibular defect resulting from a congenital condition undergoes reconstruction using a mandibular staple bone plate to improve jaw function and appearance.
9. A patient with a mandibular defect due to trauma undergoes reconstruction using a transosteal bone plate to restore proper jaw alignment and function.
10. A patient with a mandibular defect resulting from a previous tumor removal undergoes reconstruction using a mandibular staple bone plate to restore jaw structure and function.