Summary & Overview
CPT 21122: Genioplasty for Chin Asymmetry Correction
CPT code 21122 represents a multi-segment genioplasty procedure in which the surgeon incises the mandible in two or more places and removes or repositions wedges of bone to correct chin asymmetry. The code captures surgical management aimed primarily at cosmetic chin reshaping, with important functional applications such as alleviation of anatomical contributors to obstructive sleep apnea. Nationally, genioplasty is performed in both inpatient and outpatient surgical settings and involves specialties in maxillofacial and reconstructive facial surgery.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, common payer coverage considerations, and benchmarks where available. The publication outlines coding specificity for genioplasty, typical sites of service, and contextualizes the procedure within facial reconstructive and functional care pathways. It also highlights common clinical indications, utilization considerations, and the types of documentation and clinical justification payers commonly expect. Data not available in the input will be explicitly noted in relevant sections.
Billing Code Overview
CPT code 21122 describes a genioplasty procedure to correct an asymmetrical chin. The procedure involves incising the mandible in two or more places and removing or repositioning wedges of bone to reshape the chin. Genioplasty is performed primarily for cosmetic facial improvement but may also be indicated to address functional conditions such as obstructive sleep apnea.
Service type: Surgical — Maxillofacial / Reconstructive Facial Surgery
Typical site of service: Hospital operating room or ambulatory surgical center, depending on clinical complexity and facility capabilities.
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient presents to an oral and maxillofacial surgeon with a cosmetically bothersome asymmetry of the chin following congenital asymmetry and prior dental occlusion issues. The surgeon evaluates facial proportions, obtains panoramic radiographs and cone beam CT to plan a genioplasty. After discussion of risks, benefits, and alternatives, the patient elects to proceed with an open genioplasty under general anesthesia. In the operating room the surgeon makes intraoral and submental incisions, performs osteotomies of the mandibular symphysis in two or more locations, removes and repositions bone wedges to correct asymmetry, and secures the segment with plates and screws. The procedure is coded as 21122 when multiple osteotomies and wedge resections are performed to reposition the chin. Typical perioperative workflow includes preoperative imaging and clearance, intraoperative airway management, intraoperative fixation and hemostasis, postoperative monitoring in PACU, and follow-up visits for wound checks and radiographic confirmation of fixation and alignment. Indications include cosmetic chin asymmetry and functional indications such as improvement of airway dynamics in obstructive sleep apnea when chin advancement or repositioning is part of the treatment plan. Typical site of service is an ambulatory surgery center or hospital outpatient department; inpatient admission is uncommon but may occur for complex combined orthognathic procedures or medical comorbidity management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 |