Summary & Overview
CPT 21348: Repair of Nasomaxillary Complex Fracture
CPT code 21348 denotes surgical repair of fractures to the nasomaxillary complex, addressing injuries to the nose and maxilla to restore facial structure and function. This code captures clinically significant reconstructive trauma procedures that have implications for surgical resource use, facility planning, and postoperative care. Nationally, management of midface fractures is a common component of trauma and craniofacial surgical practice, making clear coding important for care coordination and claims accuracy.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 21348, typical sites of service, and which types of providers commonly perform this procedure. The publication summarizes benchmarking and policy-relevant considerations where available, clarifies common billing modifiers and coding relationships, and highlights areas where documentation supports appropriate code selection. Clinical context explains indications and procedural goals to help stakeholders interpret utilization patterns. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 21348 describes surgical repair of a fracture of the nasomaxillary complex to restore function and appearance of the nose and maxilla (jawbone). This procedure addresses traumatic injury to the bony structures of the midface and often involves reduction and fixation techniques to re-establish facial form and occlusion.
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Service type: Surgical repair of nasomaxillary complex fractures
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Typical site of service: Operating room or ambulatory surgical center, often performed by oral and maxillofacial surgeons or plastic/reconstructive surgeons
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult who presents after facial trauma from a motor vehicle collision or an assault with deformity, pain, epistaxis, and malocclusion. Imaging (CT facial bones) confirms fractures of the nasal bones and adjacent maxillary structures consistent with a nasomaxillary complex fracture. Initial evaluation in the emergency department or trauma bay addresses airway, bleeding, and cervical spine clearance. Once stabilized, the patient is taken to the operating room for definitive open or closed repair under general anesthesia. The surgical team (oral and maxillofacial surgeon, otolaryngologist, or plastic surgeon) performs reduction of displaced nasal and maxillary fractures, may place fixation (plates/screws) or perform nasal reconstruction, and controls soft tissue injuries. Intraoperative documentation includes fracture sites, reduction technique, fixation devices, estimated blood loss, and any complications. Postoperative workflow includes imaging confirmation, pain control, antibiotics if indicated, instructions on activity and follow-up visits for wound and occlusion assessment, and possible outpatient dental/maxillofacial follow-up for hardware removal or staged reconstruction.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work or time substantially exceeds usual for the procedure due to complexity (extensive comminution, multiple fracture sites). |