How To Use CPT Code 21750

CPT 21750 describes the closure of a median sternotomy separation with or without debridement. 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 21750?

CPT 21750 is a code used to describe the closure of a separation within the sternum, or breastbone, that occurs as a result of a previous surgical procedure. This closure may involve debridement, which is the surgical removal of damaged or unhealthy tissue to promote the growth of healthy tissue.

2. Official Description

The official description of CPT code 21750 is: ‘Closure of median sternotomy separation with or without debridement (separate procedure).’

3. Procedure

During the procedure for CPT 21750, the healthcare provider begins by making a longitudinal incision over the sternum. They then dissect through the tissue to visualize the bone. If necessary, the provider will debride the area by removing any damaged or unhealthy tissue. The separated sections of the bone are then realigned and stabilized by attaching wires to the bone fragments. After irrigating the area and checking for bleeding, the provider removes any instruments and closes the incision.

4. Qualifying circumstances

CPT 21750 is used when there is a separation within the sternum that requires closure. This separation typically occurs as a result of a previous surgical procedure that involved an incision in the sternum. The procedure may also involve debridement if there is damaged or unhealthy tissue present.

5. When to use CPT code 21750

CPT code 21750 should be used when a healthcare provider performs the closure of a median sternotomy separation with or without debridement. It is important to note that this code is specific to the closure of sternotomy separations and should not be used for closures in other areas of the body.

6. Documentation requirements

To support a claim for CPT 21750, the healthcare provider must document the following information:

• Patient’s medical history and the need for sternotomy closure
• Details of the procedure, including any debridement performed
• Date and duration of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 21750, ensure that the procedure meets the criteria for closure of a median sternotomy separation with or without debridement. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement. Additionally, be aware of any bundling or unbundling rules that may apply to this code.

8. Historical information

CPT 21750 was added to the Current Procedural Terminology system on January 1, 1992. Since then, there have been several historical changes to the code, including updates to the description and its inclusion on the Inpatient Only (IPO) list for Medicare. It is important to stay updated on any changes or revisions to ensure accurate coding and billing.

9. Similar codes to CPT 21750

There are several similar codes to CPT 21750 that may be used in different circumstances. These include:

• CPT 21740: Closure of sternal dehiscence, with or without mediastinitis
• CPT 21742: Reconstruction of sternum
• CPT 21743: Reconstruction of sternum with microvascular tissue transfer
• CPT 21744: Reconstruction of sternum with myocutaneous flap
• CPT 21745: Reconstruction of sternum with omental flap

9. Examples

1. A patient undergoes a previous cardiac surgery that results in a separation within the sternum. The healthcare provider performs a closure of the separation, including debridement if necessary, using CPT code 21750.
2. Following a sternotomy procedure, the patient develops a sternal dehiscence with mediastinitis. The healthcare provider performs a closure of the dehiscence using CPT code 21740.
3. A patient requires a reconstruction of the sternum due to a previous injury. The healthcare provider performs the reconstruction using CPT code 21742.
4. For a patient with a sternum defect, the healthcare provider performs a reconstruction using a microvascular tissue transfer. CPT code 21743 is used to report this procedure.
5. In a case where a patient requires a reconstruction of the sternum using a myocutaneous flap, the healthcare provider uses CPT code 21744.