How To Use CPT Code 21685

CPT code 21685 describes a surgical procedure called hyoid myotomy and suspension. 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 21685?

CPT code 21685 is used to describe a surgical procedure called hyoid myotomy and suspension. This procedure is performed to help clear the airway for patients with obstructive sleep apnea (OSA). During the procedure, the provider incises the muscle tissue around the hyoid bone, which supports the tongue, and suspends it to another structure for support.

2. Official Description

The official description of CPT code 21685 is: ‘Hyoid myotomy and suspension.’

3. Procedure

During the hyoid myotomy and suspension procedure, the patient is appropriately prepped and anesthetized. The provider makes an incision over the hyoid bone and dissects through the tissue to visualize the bone. The suprahyoid and infrahyoid muscle attachments at the top and front of the body of the hyoid bone are removed. The insertion of the stylohyoid ligament onto the lesser cornu of the hyoid bone is divided. The provider then fixes the hyoid bone to the lamina of the thyroid cartilage with sutures, passing them through the upper aspect of the thyroid cartilage and around the body of the hyoid bone. After irrigating the area and checking for bleeding, a drainage tube may be inserted. Any instruments are removed, and the incision is closed with sutures.

4. Qualifying circumstances

CPT code 21685 is used for patients with obstructive sleep apnea (OSA) who require the hyoid myotomy and suspension procedure to help clear their airway. Obstructive sleep apnea is a condition in which breathing stops intermittently for brief periods during sleep due to obstruction, narrowing, or incompetence of the airway. The procedure is performed by a qualified healthcare provider who is trained in performing hyoid myotomy and suspension.

5. When to use CPT code 21685

CPT code 21685 should be used when a patient with obstructive sleep apnea requires the hyoid myotomy and suspension procedure to improve their airway. It is important to ensure that the patient meets the qualifying circumstances for this procedure and that the provider is appropriately trained to perform it.

6. Documentation requirements

To support a claim for CPT code 21685, the healthcare provider must document the following information:

• Patient’s diagnosis of obstructive sleep apnea
• Preoperative evaluation and assessment
• Description of the procedure performed, including the incision, muscle dissection, hyoid bone fixation, and closure
• Any complications or unexpected findings during the procedure
• Postoperative care instructions
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 21685, it is important to ensure that the procedure meets the necessary criteria and that the documentation supports the medical necessity of the procedure. Preauthorization is recommended for this procedure, as coverage may vary among different insurance carriers. It is also important to follow any specific billing guidelines provided by the payer.

8. Historical information

CPT code 21685 was added to the Current Procedural Terminology system on January 1, 2004. There have been no updates to the code since its addition.

9. Similar codes to CPT 21685

There are no similar codes to CPT code 21685 within the range of repair, revision, and/or reconstruction procedures on the neck (soft tissues) and thorax.

9. Examples

1. A patient with obstructive sleep apnea undergoes hyoid myotomy and suspension to improve their airway.
2. A provider performs hyoid myotomy and suspension on a patient with severe obstructive sleep apnea who has not responded to other treatment options.
3. A patient with obstructive sleep apnea undergoes hyoid myotomy and suspension as part of a comprehensive treatment plan.
4. A provider performs hyoid myotomy and suspension on a patient with obstructive sleep apnea who is unable to tolerate continuous positive airway pressure (CPAP) therapy.
5. A patient with obstructive sleep apnea undergoes hyoid myotomy and suspension to reduce the frequency and severity of apnea episodes during sleep.
6. A provider performs hyoid myotomy and suspension on a patient with obstructive sleep apnea who has anatomical abnormalities contributing to airway obstruction.
7. A patient with obstructive sleep apnea undergoes hyoid myotomy and suspension to improve their quality of sleep and reduce daytime sleepiness.
8. A provider performs hyoid myotomy and suspension on a patient with obstructive sleep apnea who has failed to respond to other surgical interventions.
9. A patient with obstructive sleep apnea undergoes hyoid myotomy and suspension to improve their overall respiratory function and oxygenation.
10. A provider performs hyoid myotomy and suspension on a patient with obstructive sleep apnea who has significant airway collapse during sleep.