Summary & Overview
CPT 21343: Repair of Depressed Frontal Sinus Fracture
CPT code 21343 covers open surgical repair of depressed fractures of the frontal sinus below the brow ridge, typically required after blunt force or crush trauma to the forehead. This procedure is clinically significant because it addresses both functional and cosmetic consequences of frontal bone fractures, can involve complex reduction and fixation, and is frequently performed in acute trauma and facial reconstruction settings. Nationally, management of frontal sinus fractures has implications for trauma systems, craniofacial surgery practice patterns, and payer coverage for operative repair.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for 21343, typical sites of service, and what to expect in coding and billing workflows. The publication summarizes common modifier usage and related service-line considerations, highlights typical payment and coverage themes across major payers, and provides benchmark indicators and policy updates relevant to trauma and reconstructive facial surgery. Clinical details outline indications for repair, procedural setting, and implications for post-operative care and follow-up.
Data not available in the input for associated taxonomies, ICD-10 diagnoses, specific payer policies, and related codes.
Billing Code Overview
CPT code 21343 describes a surgical repair of a depressed fracture of the frontal sinus bones below the brow ridge, performed through an incision to access and reduce the fracture. The procedure addresses structural damage resulting from blunt force trauma or crush injuries to the frontal sinus region.
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Service type: Open surgical repair of facial/craniofacial bone fracture
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Typical site of service: Operating room or ambulatory surgical center, performed by a craniofacial, plastic, or maxillofacial surgeon
Clinical & Coding Specifications
Clinical Context
A 34-year-old male presents to the emergency department after a motor vehicle collision with direct blunt trauma to the forehead. He has localized depression of the supraorbital ridge with visible contour deformity, periorbital swelling, and reported numbness of the forehead. CT facial bones demonstrates a depressed fracture of the frontal sinus below the brow ridge without intracranial extension. The patient is taken to the operating room for open repair: the surgeon makes an incision along the brow to access the depressed frontal sinus fracture, elevates and repairs the depressed bone fragments, restores the contour, inspects and irrigates the sinus, and secures fixation as needed. Typical clinical workflow includes preoperative imaging (CT), informed consent, perioperative antibiotics, OR repair under general anesthesia, postoperative head elevation and sinus precautions, and outpatient follow-up for wound check and cosmetic/function assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or technical difficulty substantially exceeds typical for 21343. |
23 |