Summary & Overview
CPT 21340: Open Repair of Nasal and Ethmoid Fracture
CPT code 21340 covers open surgical repair of fractures of the nasal and ethmoid bones via a skin incision, including necessary soft-tissue repair and application of a fixation device. This code captures definitive operative management of displaced or complex nasal-ethmoid fractures that require direct visualization and stabilization, and is important nationally for surgical billing, trauma care pathways, and facility resource planning. Key payers typically involved in coverage decisions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find clinical context on the procedure type and typical care setting, plus analysis-ready information on payer coverage patterns and benchmarking where available. The publication includes benchmarks for utilization and payments, coding guidance relevant to surgical service lines, and discussion of policy updates that affect outpatient surgical reimbursement and facility designation. Practical items covered include typical sites of service, common clinical indications for open repair versus closed management, and implications for surgical teams and billing departments. Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Billing Code Overview
CPT code 21340 describes open repair of fractures of the nasal and ethmoid bones performed through a skin incision to restore function and appearance. The procedure includes repair of adjacent tissues and structures as needed and placement of a fixation device to stabilize the fracture during healing.
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Service type: Open surgical fracture repair of the nasal and ethmoid bones, including soft-tissue reconstruction as indicated.
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Typical site of service: Operating room or ambulatory surgical center for facial trauma surgery, with possible short inpatient stays depending on injury severity and patient factors.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after an assault with facial trauma. He reports nasal deformity, epistaxis, nasal obstruction, and periorbital swelling. Physical exam demonstrates crepitus over the nasal bridge, a displaced nasal bone and ethmoid fracture with septal deviation, and external laceration near the nasal dorsum. Imaging (facial CT) confirms displaced fractures of the nasal and ethmoid bones requiring open reduction. The surgical workflow includes preoperative evaluation, informed consent, administration of general anesthesia, a transcutaneous skin incision to access nasal and ethmoid bones, open reduction of the fractures, repair of associated soft tissue and septal structures as needed, and fixation with internal devices (e.g., plates/screws or transcutaneous fixation). Postoperative care includes nasal packing or external splinting, pain control, instructions for activity restriction, and follow-up for wound and hardware assessment. Common settings for this procedure are the operating room in an acute care hospital or an ambulatory surgery center depending on patient stability and complexity of associated injuries.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or intensity significantly exceeds typical for 21340 (document rationale). |