Summary & Overview
CPT 21345: Nasomaxillary Complex Fracture Repair
CPT code 21345 covers surgical repair of nasomaxillary complex fractures—procedures aimed at restoring form and function after traumatic injury to the nasal bones and maxilla, with stabilization using splints or fixation devices. This code is nationally relevant because facial fracture repair is common in trauma and maxillofacial surgery, involves multiple provider types, and intersects with hospital operative services and post-operative care pathways. Payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and billing overview, national benchmarks where available, and policy context affecting coverage and claims processing for operative facial fracture repair. The publication highlights typical sites of service, common billing considerations, and areas where documentation and coding specificity often affect payment. Data not available in the input is noted where applicable for supplemental topics such as payer-specific reimbursement rates, taxonomies, and ICD-10 pairings.
Billing Code Overview
CPT code 21345 describes surgical repair of a nasomaxillary complex fracture to treat injury to the nasal bones and the maxilla (upper jaw). The procedure includes restoration of facial structure and function, with application of a splint or other fixation device to stabilize the repair during healing.
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Service type: Surgical repair of facial fractures (open or closed repair with fixation as indicated)
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Typical site of service: Hospital operating room or ambulatory surgical center for operative management; may involve post-operative care in inpatient or outpatient clinic settings
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to the emergency department after a motor vehicle collision with facial pain, nasal deformity, epistaxis, malocclusion of the upper teeth and periorbital swelling. CT maxillofacial imaging demonstrates a displaced nasomaxillary complex fracture involving the nasal bones and the maxilla with instability of the nasal pyramid and disruption of the maxillary buttress. The patient is taken to the operating room for open reduction and internal fixation of the nasomaxillary complex to restore facial form and occlusion. The surgeon performs reduction of fractures, applies internal fixation (plates and screws) to the maxilla as indicated, repositions and stabilizes the nasal bones, and applies an external nasal splint or internal intranasal splints to maintain alignment during healing. Intraoperative steps include exposure of fracture sites, debridement of bone fragments, anatomic reduction, fixation, hemostasis, and application of fixation/splinting devices. Typical perioperative workflow includes preoperative imaging review, informed consent, general anesthesia, operative repair, immediate postoperative assessment, and placement of postoperative instructions for splint care and follow-up visits for splint removal and assessment of healing. Typical site of service is the operating room in an acute care hospital or ambulatory surgical center depending on injury severity and comorbidities. Service type: surgical repair of facial fractures with fixation/splinting for the nasomaxillary complex (21345).
Coding Specifications
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