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Craniofacial Reconstruction

Denise Posted Thu 16th of May, 2019 19:16:44 PM
My surgeon is doing mid-face distraction surgery on a child with a Le-Forte 3 and Halo. He is designing the implants to be used for the mid-face reconstruction. I have 2 questions. One is there a CPT code for the time he spends for the time he spends designing the implants they take him about 45 minutes to an 1 to design. They are called CAD/CAM surgical implants. The implants will be manufactured and the facility will be billing for them. And 2 what are the correct CPT codes for the surgery?
SuperCoder Answered Fri 17th of May, 2019 04:37:06 AM

 

Hi Denise,

 

Mid face reconstruction surgery with Lefort III and Halo is coded as per the procedures performed. There are multiple ways in which mid face reconstruction procedure is performed. Below mentioned are the details:

 

CPT code 21154 - Reconstruction midface, LeFort III (extracranial), any type, requiring bone graft (includes obtaining autografts); without LeFort I

 

CPT code 21155 - Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I

 

CPT code 21159 - Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (e.g., mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I

 

CPT code 21160 - Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (e.g., mono bloc), requiring bone grafts (includes obtaining autografts); with LeFort I

 

 

You should use CPT code 20661 for application of Halo.

 

Also, CAD/CAM implants are considered dental implants and are not payable services.

 

Thanks!

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