How To Use CPT Code 21453

CPT code 21453 describes the closed treatment of a mandibular fracture with interdental fixation. 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 21453?

CPT 21453 is used to describe the closed treatment of a mandibular fracture with interdental fixation. This procedure involves repairing damage to the lower jaw bone caused by blunt force trauma to the face. The provider manipulates the fractured bones into the appropriate position and uses wires, dentures, or splints attached to the teeth to hold the fracture in place and provide stabilization while it heals.

2. Official Description

The official description of CPT code 21453 is: ‘Closed treatment of mandibular fracture with interdental fixation.’

3. Procedure

During the procedure for CPT 21453, the provider first prepares and anesthetizes the patient. They then manipulate the fractured mandible bones into the proper alignment. To hold the fracture in place and provide stabilization, the provider uses wires, dentures, or splints that are attached to the teeth. This interdental fixation device secures the fractured bones and allows for proper healing.

4. Qualifying circumstances

CPT 21453 is used when a patient has a mandibular fracture that requires closed treatment with interdental fixation. This procedure is typically performed when the fracture does not communicate with the outside environment and can be repaired without surgically opening the injury. It is important to note that closed treatment may also include manipulation to realign the fractured bones.

5. When to use CPT code 21453

CPT code 21453 should be used when a provider performs closed treatment of a mandibular fracture with interdental fixation. This code is appropriate when the fracture does not require surgical intervention and can be repaired using wires, dentures, or splints attached to the teeth. If the fracture requires open treatment or the use of plates and screws for stabilization, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 21453, the provider must document the following information:

• Patient’s diagnosis of a mandibular fracture
• Details of the closed treatment procedure performed
• Specific interdental fixation device used
• Date of the procedure
• Any additional relevant information, such as manipulation of the fractured bones
• Signature of the provider

7. Billing guidelines

When billing for CPT 21453, ensure that the procedure performed meets the criteria for closed treatment of a mandibular fracture with interdental fixation. It is important to accurately document the procedure and use the appropriate CPT code. If the fracture requires open treatment or the use of plates and screws, a different CPT code should be used. Additionally, follow any specific billing guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT code 21453 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 21453

There are several similar codes to CPT 21453 that describe different procedures for mandibular fractures. These include:

• CPT 21450: Open treatment of mandibular fracture with interdental fixation
• CPT 21452: Closed treatment of mandibular fracture without interdental fixation
• CPT 21454: Open treatment of mandibular fracture without interdental fixation
• CPT 21455: Open treatment of mandibular fracture with interdental fixation and bone graft
• CPT 21456: Open treatment of mandibular fracture without interdental fixation and bone graft

9. Examples

1. A patient sustains a mandibular fracture due to a car accident. The provider performs closed treatment with interdental fixation using wires attached to the teeth.
2. An individual is involved in a physical altercation and suffers a mandibular fracture. The provider manipulates the fractured bones into alignment and uses splints attached to the teeth for stabilization.
3. A patient falls and fractures their mandible. The provider performs closed treatment with interdental fixation using dentures to hold the fracture in place.
4. Someone sustains a mandibular fracture while playing sports. The provider performs closed treatment with interdental fixation using wires attached to the teeth.
5. An individual is involved in a workplace accident and fractures their mandible. The provider manipulates the fractured bones into alignment and uses splints attached to the teeth for stabilization.
6. A patient sustains a mandibular fracture due to a fall. The provider performs closed treatment with interdental fixation using dentures to hold the fracture in place.
7. Someone sustains a mandibular fracture while participating in recreational activities. The provider performs closed treatment with interdental fixation using wires attached to the teeth.
8. An individual is involved in a physical altercation and fractures their mandible. The provider manipulates the fractured bones into alignment and uses splints attached to the teeth for stabilization.
9. A patient falls and fractures their mandible. The provider performs closed treatment with interdental fixation using dentures to hold the fracture in place.
10. Someone sustains a mandibular fracture while playing sports. The provider performs closed treatment with interdental fixation using wires attached to the teeth.