How To Use CPT Code 21451

CPT code 21451 describes the closed treatment of a mandibular fracture with manipulation. 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 21451?

CPT 21451 is used to describe the closed treatment of a mandibular fracture with manipulation. This code is used when a healthcare provider repairs damage to the lower jaw caused by blunt force trauma to the face. The provider uses manipulation techniques to realign the fractured bone without making an incision.

2. Official Description

The official description of CPT code 21451 is: ‘Closed treatment of mandibular fracture with manipulation.’

3. Procedure

The procedure for CPT 21451 involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider examines the patient to assess the mandibular fracture.
3. The provider uses manipulation techniques to reduce, or realign, the fractured bone back into its proper positioning.
4. A modified diet may be prescribed to limit movement of the jaw while the fracture heals.

4. Qualifying circumstances

CPT 21451 is used for patients who have sustained a mandibular fracture due to blunt force trauma to the face. The fracture must be treated with closed manipulation techniques, without the need for an incision. The patient must meet the specific criteria for this procedure, as determined by the healthcare provider.

5. When to use CPT code 21451

CPT code 21451 should be used when a healthcare provider performs closed treatment of a mandibular fracture using manipulation techniques. This code should not be used if an incision is made during the procedure or if a different treatment method is used.

6. Documentation requirements

To support a claim for CPT 21451, the healthcare provider must document the following information:

• Patient’s diagnosis of a mandibular fracture
• Details of the closed treatment procedure performed, including the manipulation techniques used
• Date of the procedure
• Any additional instructions or prescriptions given to the patient
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 21451, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the procedure and provide any necessary supporting documentation. CPT code 21451 should not be reported with other codes unless there are additional procedures performed that are separately reportable.

8. Historical information

CPT code 21451 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. Examples

1. A patient sustains a mandibular fracture due to a car accident. The healthcare provider performs closed treatment of the fracture using manipulation techniques.
2. A patient is involved in a physical altercation and suffers a mandibular fracture. The healthcare provider uses closed manipulation to realign the fractured bone.
3. A patient falls and fractures their lower jaw. The healthcare provider performs closed treatment of the fracture without the need for an incision.
4. A patient is injured during a sporting event and presents with a mandibular fracture. The healthcare provider uses closed manipulation techniques to treat the fracture.
5. A patient is assaulted and sustains a mandibular fracture. The healthcare provider performs closed treatment of the fracture using manipulation techniques.
6. A patient is involved in a workplace accident and fractures their lower jaw. The healthcare provider uses closed manipulation to realign the fractured bone.
7. A patient is injured in a fall and presents with a mandibular fracture. The healthcare provider performs closed treatment of the fracture without the need for an incision.
8. A patient is involved in a physical altercation and sustains a mandibular fracture. The healthcare provider uses closed manipulation techniques to treat the fracture.
9. A patient is injured during a sporting event and fractures their lower jaw. The healthcare provider performs closed treatment of the fracture using manipulation techniques.
10. A patient is assaulted and sustains a mandibular fracture. The healthcare provider uses closed manipulation to realign the fractured bone.