Anesthesia Coding Alert
Base Malar Tripod Code on Approach
West Virginia Subscriber
Answer: Choose the procedure code based on whether the surgeon uses an open or percutaneous approach and how complicated the repair was.
Start by basing your coding on surgical codes 21355 (Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation), 21360 (Open treatment of depressed malar fracture, including zygomatic arch and malar tripod) or 21365 (Open treatment of complicated [e.g., comminuted or involving cranial nerve foramina] fracture[s] of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches), depending on the case.
Surgical code 21355 crosses to anesthesia code 00190 (Anesthesia for procedure on facial bones or skull; not otherwise specified), and codes 21360 and 21365 cross to anesthesia code 00192 (Anesthesia for procedures on facial bones or skull; radical surgery [including prognathism]).
The correct diagnosis code is 802.4 (Fracture of face bones; malar and maxillary bones, closed).
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