How To Use CPT Code 21340

CPT 21340 describes the percutaneous treatment of a nasoethmoid complex fracture, including the repair of canthal ligaments and/or the nasolacrimal apparatus. 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 21340?

CPT 21340 is a code used to describe the percutaneous treatment of a nasoethmoid complex fracture. This procedure involves the repair of the fracture in the nasal and ethmoid bones, as well as the repair of other tissues and structures in the area. The provider may also apply a fixation device, such as a splint, wire, or headcap, to stabilize the fracture as it heals.

2. Official Description

The official description of CPT code 21340 is: ‘Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and/or the nasolacrimal apparatus.’

3. Procedure

The procedure for CPT 21340 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The provider makes puncture incisions in the patient’s nose over the fracture.
3. The provider accesses the nasoethmoid fracture through these percutaneous puncture sites.
4. The provider reduces, or realigns, the fracture using small wires and/or splints to hold it in place.
5. The provider repairs the canthal ligaments and/or the nasolacrimal apparatus, if necessary.
6. The provider may attach a fixation device, such as a halo or headcap, for stabilization.

4. Qualifying circumstances

CPT 21340 is used for patients who have a nasoethmoid complex fracture that requires percutaneous treatment. This procedure is typically performed to restore function and appearance. The repair of canthal ligaments and/or the nasolacrimal apparatus may be necessary depending on the specific case. It is important to note that this code is specific to the percutaneous treatment of a nasoethmoid complex fracture and should not be used for other types of fractures or procedures.

5. When to use CPT code 21340

CPT code 21340 should be used when a provider performs the percutaneous treatment of a nasoethmoid complex fracture, including the repair of canthal ligaments and/or the nasolacrimal apparatus. It is important to ensure that the procedure performed aligns with the description provided by the code. If the procedure does not meet the specific criteria outlined in the code description, an alternative code should be used.

6. Documentation requirements

To support a claim for CPT 21340, the provider must document the following information:

• Patient’s diagnosis of a nasoethmoid complex fracture
• Details of the percutaneous treatment performed
• Repair of canthal ligaments and/or the nasolacrimal apparatus, if applicable
• Use of any fixation devices, such as splints, wires, or headcaps
• Any additional procedures or repairs performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 21340, it is important to ensure that the procedure performed aligns with the code description. The provider should use the appropriate modifiers, if applicable, to indicate any additional procedures or repairs performed during the same session. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 21340 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 21340

There are several similar codes to CPT 21340 that may be used for related procedures. These include:

• CPT 21315: Treatment of nasal bone fracture
• CPT 21320: Treatment of nasal bone fracture with manipulation
• CPT 21325: Treatment of nasal bone fracture with internal fixation
• CPT 21335: Treatment of nasal bone fracture with external fixation
• CPT 21497: Treatment of zygomatic fracture

9. Examples

1. A patient sustains a nasoethmoid complex fracture due to a traumatic injury. The provider performs percutaneous treatment, including the repair of canthal ligaments and the nasolacrimal apparatus, using a splint for stabilization.
2. A patient presents with a nasoethmoid complex fracture resulting from a sports-related accident. The provider performs percutaneous treatment, repairs the canthal ligaments, and applies a headcap fixation device to stabilize the fracture.
3. A patient undergoes percutaneous treatment for a nasoethmoid complex fracture caused by a motor vehicle accident. The provider repairs the nasolacrimal apparatus and uses wires for fixation.
4. A patient requires percutaneous treatment for a nasoethmoid complex fracture following a fall. The provider repairs the canthal ligaments and applies a splint for stabilization.
5. A patient sustains a nasoethmoid complex fracture during a physical altercation. The provider performs percutaneous treatment, repairs the nasolacrimal apparatus, and uses a headcap fixation device for stabilization.
6. A patient presents with a nasoethmoid complex fracture resulting from a workplace accident. The provider performs percutaneous treatment, repairs the canthal ligaments, and applies a halo fixation device for stabilization.
7. A patient undergoes percutaneous treatment for a nasoethmoid complex fracture caused by a sports-related injury. The provider repairs the nasolacrimal apparatus and uses wires for fixation.
8. A patient requires percutaneous treatment for a nasoethmoid complex fracture following a fall. The provider repairs the canthal ligaments and applies a splint for stabilization.
9. A patient sustains a nasoethmoid complex fracture during a physical altercation. The provider performs percutaneous treatment, repairs the nasolacrimal apparatus, and uses a headcap fixation device for stabilization.