Summary & Overview
CPT 21123: Sliding Genioplasty with Autologous Chin Augmentation
CPT code 21123 covers sliding genioplasty with autologous bone graft augmentation of the chin, a surgical procedure used to improve facial aesthetics or address functional conditions such as obstructive sleep apnea. This code represents a specialized maxillofacial operation that can affect airway mechanics and facial profile, making it relevant to plastic surgery, oral and maxillofacial surgery, and sleep medicine. Nationally, accurate coding for 21123 matters for appropriate clinical documentation, surgical quality measurement, and payer policy alignment.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical intent of the procedure, where it is typically performed, common modifiers associated with surgical services, and the payer landscape relevant to coverage and claims processing. The publication provides benchmarks for utilization and reimbursement patterns where available, clarifies coding boundaries for related facial osteotomies, and summarizes policy considerations that influence preauthorization and medical necessity determinations.
Data not available in the input: associated taxonomies, specific ICD-10 diagnoses, related codes, and payer-specific coverage edits. The content is intended for a national audience of clinicians, coding professionals, and policy analysts.
Billing Code Overview
CPT code 21123 describes an augmentation of the chin using a sliding genioplasty with autologous bone grafting. The procedure involves sliding the chin bone forward and layering the patient’s own bone to build up the chin for cosmetic improvement or to address functional issues such as obstructive sleep apnea.
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Service type: Surgical facial bone augmentation (genioplasty)
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Typical site of service: Hospital operating room or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 28-year-old adult presents to an oral and maxillofacial surgery clinic seeking correction of chin retrusion causing facial aesthetic concern and functional bite imbalance. The patient reports difficulty with lower facial projection and requests surgical augmentation. Clinical evaluation and cephalometric analysis demonstrate mandibular hypoplasia amenable to sliding genioplasty with autogenous bone grafting. Preoperative workflow includes history and physical, photographic documentation, dental impressions or models, and informed consent. On the day of surgery the patient undergoes general anesthesia in an ambulatory surgery center; the surgeon performs an intraoral sliding genioplasty, advances the mentum segment anteriorly, and layers autogenous corticocancellous bone harvested from the mandibular ramus to augment chin projection. Hemostasis is achieved, fixation is secured with plates and screws, and the oral mucosa is closed. Postoperative care includes short observation in PACU, discharge with analgesics and antibiotics as indicated, and follow-up visits for wound inspection and radiographic assessment of fixation and bone graft incorporation. Indications for this procedure include cosmetic chin augmentation and functional correction related to occlusion or airway concerns such as mild mandibular deficiency contributing to obstructive sleep apnea symptoms.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Reserved for future use by some payors (not standard CMS) | Use only if a specific payer requires this administrative placeholder |