Otolaryngology Coding Alert
Choose Between 21452 and 21453 for Mandibular Fracture Fixation
Question: The otolaryngologist did several procedures to repair multiple fractures to a patient’s face. His only description in the op note for repairing the mandible fracture reads, “The patient will be placed into maxillary mandibular fixation for treatment of his mandibular fracture.” CPT® code 21497 is for interdental wiring but I didn’t think that was the correct code in this situation. What should we report?
Virginia Subscriber
Answer: You’re correct in thinking that 21497 (Interdental wiring, for condition other than fracture) isn’t the correct choice in this instance.
Your provider used a fixation device to treat the mandibular fracture. Your best options are 21452 (Percutaneous treatment of mandibular fracture, with external fixation) or 21453 (Closed treatment of mandibular fracture with interdental fixation), depending on whether you’re reporting percutaneous or closed treatment. Code 21452 might be the more accurate choice if the physician did not document using interdental fixation to hold the fracture in place during healing. Query the physician if the op note is not clear as to the approach and if the interdental fixation was used. Point out to your surgeon how this information has to be included in the op note.
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