Wiki MULTIPLE MANDIBLE FRACTURES

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sbuck328

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Does anyone know if we are able to bill CPT 21462 more than once per session if there are multiple fractures on different parts of the mandible or for bilateral fractures?
Thank you!
 
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sbuck328 said:
Does anyone know if we are able to bill CPT 21462 more than once per session if there are multiple fractures on different parts of the mandible or for bilateral fractures?
Thank you!
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Just remember, if there were multiple fractures of the mandible what are their locations as there are different codes for specific mandible anatomy. Also consider the use of Mod. 22 - Increased Procedural Services, this could assist when there are mulitple fractures of the mandible with plating, not just one fracture.


CPT 21462 - The provider treats a fracture of the mandible, or lower jaw bone, to repair damage caused by blunt force trauma to the face. He accesses the fracture through an incision and applies a fixation device that attaches to the teeth to secure the fracture while it heals.

Clinical Responsibility
When the patient is appropriately prepped and anesthetized, the provider makes an incision over the mandible and dissects through the fascia and down to the fracture site. He reduces, or realigns, the fractured bones back into their proper positions. He applies interdental wiring or arch bars to stabilize the jaw and allow the fracture to heal. The provider then irrigates the wound and closes the incision.

Terminology
Arch bar: Device used to provide stabilization of the jaw or teeth following oral surgery; arch bars follow the natural arch, or curve of the teeth.

Fascia: Fatty or fibrous connective tissue that covers, protects, and gives support to other structures; superficial fascia is immediately below the skin; deep fascia surrounds deeper structures such as muscles, bones, nerves, and blood vessels.

Fracture: To break; also a broken bone.
Interdental: Between the teeth.
Interdental fixation device: Medical appliance that is fixed, or connected, to the teeth to hold the device in place.

Tips
If you need to report more than one code for an uncomplicated fracture, such as 21462 for an angle fracture in association with a condyle fracture, 21465, Open treatment of mandibular condylar fracture, append modifier 51, Multiple procedures, to the second code.
 
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I am coding for an angle fracture of the left mandible and a parasymphyseal fracture of the right mandible, both with interdental fixation.
Thank you.
 
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You may want to consider CPT 21470 if the operative note supports it. See the "Tips" at the end.

CPT 21470 - Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and/or wiring of dentures or splints

The provider treats a complicated fracture of the mandible, or lower jaw bone, to repair damage caused by blunt force trauma to the face. He accesses the fracture through multiple incisions and applies a fixation device to secure the fracture while it heals.

Clinical Responsibility
When the patient is appropriately prepped and anesthetized, the provider makes incisions in front of the ear and along the jawbone. He then dissects down to the fractured bones. He reduces, or realigns, the mandibular fracture and places wires and screws along the upper and lower arches to stabilize the fracture. He attaches metal wires around the teeth and secures them to arch bars for fixation. The provider then irrigates the area, checks for bleeding, removes any instruments, and closes the incisions.

Terminology
Arch bar: Device used to provide stabilization of the jaw or teeth following oral surgery; arch bars follow the natural arch, or curve of the teeth.

Fascia: Fatty or fibrous connective tissue that covers, protects, and gives support to other structures; superficial fascia is immediately below the skin; deep fascia surrounds deeper structures such as muscles, bones, nerves, and blood vessels.

Fracture: To break; also a broken bone.

Interdental: Between the teeth.

Interdental fixation device: Medical appliance that is fixed, or connected, to the teeth to hold the device in place.

Tips
When there are multiple fractures, it can be difficult to distinguish between 21465 and 21470, Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and or wiring of dentures or splints, when the provider uses multiple approaches to access a single, complicated fracture site. If he accesses multiple fracture sites, choose between 21465 and other appropriate codes such as 21461, Open treatment of mandibular fracture, without interdental fixation, or 21462, Open treatment of mandibular fracture, with interdental fixation. If the provider treats two complicated sites, however, report 21470 twice and append modifier 52, Reduced services, to the second code because he only wires the patient's jaw shut once. But if you report more than one code for less complicated fractures, such as 21462, Open treatment of mandibular fracture, with interdental fixation, in the case of an angle fracture, along with 21465 for the condyle fracture, append modifier 51, Multiple procedures, to the second code instead.
 
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