How To Use CPT Code 21740

CPT 21740 describes the reconstructive repair of pectus excavatum or carinatum, which are congenital deformities of the chest wall. 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 21740?

CPT 21740 is used to describe the reconstructive repair of pectus excavatum or carinatum, which are congenital deformities of the chest wall. This code is used when a provider performs an open procedure to correct the sunken chest deformity (pectus excavatum) or protruding sternum deformity (pectus carinatum).

2. Official Description

The official description of CPT code 21740 is: ‘Reconstructive repair of pectus excavatum or carinatum, open.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider makes a transverse, or horizontal, curvilinear incision over the sternum.
3. The provider dissects through the tissue until reaching the bone.
4. The lower cartilages are removed, and a wedge osteotomy is performed on the sternum.
5. A wire is placed behind the sternum and attached to a steel bar to correct the deformity.
6. The area is irrigated, checked for bleeding, and any instruments are removed.
7. The incision is closed.

4. Qualifying circumstances

CPT 21740 is used for patients with congenital deformities of the chest wall, specifically pectus excavatum or carinatum. These deformities are present from birth and require reconstructive repair to correct the chest wall appearance. The procedure is performed by a qualified provider and is typically done on patients who have an unstable sternum that requires the attachment of sternal plates and wires.

5. When to use CPT code 21740

CPT code 21740 should be used when a provider performs an open reconstructive repair of pectus excavatum or carinatum. It is important to ensure that the procedure meets the specific criteria outlined in the code description, including the use of an open approach and the correction of the congenital deformity.

6. Documentation requirements

To support a claim for CPT 21740, the provider must document the following information:

• Patient’s diagnosis of pectus excavatum or carinatum
• Description of the procedure performed, including the specific techniques used
• Date of the procedure
• Any additional procedures or interventions performed during the same operative session
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 21740, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the procedure and any additional services provided during the same operative session. Report any complications or unexpected findings separately, if applicable.

8. Historical information

CPT 21740 was added to the Current Procedural Terminology system on January 1, 1990. It has undergone several changes, including being added and removed from the Inpatient Only (IPO) list by Medicare.

9. Examples

1. A provider performs an open reconstructive repair of pectus excavatum for a patient with a sunken chest deformity.
2. A patient undergoes an open procedure to correct a protruding sternum deformity using CPT code 21740.
3. A provider performs a reconstructive repair of pectus carinatum using an open approach.
4. A patient with a congenital chest wall deformity undergoes an open procedure to correct the appearance of their chest.
5. A provider performs an open reconstructive repair of pectus excavatum, attaching sternal plates and wires to stabilize the sternum.
6. A patient with a congenital deformity of the chest wall undergoes an open procedure to correct the appearance of their chest using CPT code 21740.
7. A provider performs an open reconstructive repair of pectus carinatum, using a steel bar to correct the protruding sternum.
8. A patient with a congenital chest wall deformity undergoes an open procedure to correct the appearance of their chest, using CPT code 21740.
9. A provider performs an open reconstructive repair of pectus excavatum, removing lower cartilages and performing a wedge osteotomy on the sternum.
10. A patient with a sunken chest deformity undergoes an open procedure to correct the appearance of their chest using CPT code 21740.