Wiki facial fractures

[jocoffey]

Hi all,

Can anyone help me in billing for cpt code 21347, our doctors says we can bill 21347 for the right side and 21347-59 for the left side. Has anyone bill this code this way and gotten paid? please advise. Thanks

 

[JenniferB7]

Since a LeFort Fracture is bilateral, CPT code 21347 is also bilateral and should not be billed with a 50 modifier or as a unilateral code.

Karen Zupko & Associates, PC gives a good Q&A explanation in their coding archives:

"
Question:
I performed open reduction internal fixation of bilateral Le Fort II fractures through multiple approaches. Would this be coded as 21347-50? Otherwise asked, does 21347 constitute a repair of a unilateral Le Fort fracture?

Answer:
The Le Fort fracture repair codes should not be reported with the bilateral modifier (50). A Le Fort fracture is inherently bilateral; therefore, the repair procedure (and CPT code) is also inherently bilateral."

http://www.karenzupko.com/resources/codingcoach/cc_plasticsarchive_2012.html

Hope that helps.

Jennifer M. Connell, BA, CPC, CENTC, CPCO