How To Use CPT Code 21345

CPT code 21345 describes the closed treatment of a nasomaxillary complex fracture, specifically a LeFort II type fracture. 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 21345?

CPT 21345 is used to describe the closed treatment of a nasomaxillary complex fracture, specifically a LeFort II type fracture. This procedure involves the repair of bones in the nose and upper jaw to restore function and appearance. The provider applies a splint or other fixation device to stabilize the repair as it heals.

2. Official Description

The official description of CPT code 21345 is: ‘Closed treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint.’

3. Procedure

When performing CPT 21345, the provider begins by appropriately prepping and anesthetizing the patient. The fracture is accessed from inside the patient’s mouth. The provider then resets the fractured bones into their proper position using manipulation techniques. Once the bones are aligned, interdental wiring is used to fix the upper jaw in place. The provider may also irrigate the mouth and apply a denture or external splint to further stabilize the injury, if necessary.

4. Qualifying circumstances

CPT 21345 is used for patients with a nasomaxillary complex fracture, specifically a LeFort II type fracture. This type of fracture involves the bones in the nose and upper jaw. The procedure is performed to restore function and appearance. The patient must meet the criteria for a closed treatment, meaning the fracture is manipulated and stabilized without an open surgical approach. The use of interdental wire fixation or fixation of a denture or splint is also required.

5. When to use CPT code 21345

CPT code 21345 should be used when a provider performs a closed treatment of a nasomaxillary complex fracture, specifically a LeFort II type fracture, using interdental wire fixation or fixation of a denture or splint. It is important to ensure that the procedure meets all the qualifying circumstances and is documented appropriately.

6. Documentation requirements

To support a claim for CPT 21345, the provider must document the following information:

• Patient’s diagnosis of a nasomaxillary complex fracture, specifically a LeFort II type fracture
• Details of the closed treatment procedure performed
• Use of interdental wire fixation or fixation of a denture or splint
• Date of the procedure
• Any additional relevant information or complications
• Signature of the provider

7. Billing guidelines

When billing for CPT 21345, ensure that the procedure meets all the qualifying circumstances and is documented appropriately. It is important to follow the specific guidelines set forth by the payer and to use the correct coding modifiers, if applicable. Additionally, be aware of any bundling or unbundling issues that may affect the billing of this code.

8. Historical information

CPT 21345 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 21345

There are several similar codes to CPT 21345 that may be used in different circumstances. These include:

• CPT 21335: Closed treatment of nasomaxillary complex fracture (LeFort I type), without interdental wire fixation or fixation of denture or splint
• CPT 21337: Closed treatment of nasomaxillary complex fracture (LeFort III type), without interdental wire fixation or fixation of denture or splint
• CPT 21347: Open treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint
• CPT 21348: Open treatment of nasomaxillary complex fracture (LeFort III type), with interdental wire fixation or fixation of denture or splint
• CPT 21349: Open treatment of nasomaxillary complex fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint

9. Examples

1. A patient sustains a LeFort II type fracture in a car accident. The provider performs a closed treatment using interdental wire fixation to stabilize the fracture.
2. An individual falls and fractures their nose and upper jaw. The provider performs a closed treatment of the nasomaxillary complex fracture, utilizing a splint for stabilization.
3. A patient presents with a LeFort II type fracture resulting from a sports injury. The provider performs a closed treatment, using interdental wire fixation and a denture for stabilization.
4. Following a physical altercation, a patient is diagnosed with a nasomaxillary complex fracture. The provider performs a closed treatment, utilizing interdental wire fixation and a splint for stabilization.
5. An individual sustains a LeFort II type fracture in a workplace accident. The provider performs a closed treatment, using interdental wire fixation and a denture for stabilization.
6. A patient is involved in a severe fall, resulting in a nasomaxillary complex fracture. The provider performs a closed treatment, utilizing interdental wire fixation and a splint for stabilization.
7. An individual is injured in a motor vehicle accident and is diagnosed with a LeFort II type fracture. The provider performs a closed treatment, using interdental wire fixation and a denture for stabilization.
8. A patient sustains a nasomaxillary complex fracture during a sporting event. The provider performs a closed treatment, utilizing interdental wire fixation and a splint for stabilization.
9. An individual is involved in a physical altercation and suffers a LeFort II type fracture. The provider performs a closed treatment, using interdental wire fixation and a denture for stabilization.
10. A patient presents with a nasomaxillary complex fracture resulting from a fall. The provider performs a closed treatment, utilizing interdental wire fixation and a splint for stabilization.