Oral Surgery Coding & Reimbursement Alert

You Be the Coder:

Know Your Options for Reporting Intermaxillary Screw Fixation

Question: Our surgeon recently performed intermixed maxillary mandibular fixation using the Matrix wave with application of wires for intermaxillary fixation. Can you let me know what CPT® code I have to report for the procedure that our surgeon performed?

New York Subscriber

Answer: The Matrix wave maxillomandibular fixation system is a wave type of plate and screw system that your surgeon will use to stabilize the jaw bones. Your clinician will place self-drilling lock screws and plates to help stabilize the maxilla or the mandible following trauma or during reconstruction.

Some of the indications for which your clinician might use this kind of a fixation will be for the stabilization of the jaw bones following a fracture. This fixation system will be used by your clinician for treatment of simple fractures where the fractured segments are not displaced. Your clinician could also use it for temporary stabilization during an osteotomy or during orthognathic surgical procedures.

You have not mentioned what procedure your surgeon used the matrix wave fixation for. If it was for the stabilization of a fracture, you will have to report it with a closed treatment code as the procedure does not involve an open method of treatment.

For instance, if your clinician used the fixation for the reduction of a mandibular fracture, you will have to report it with the CPT® code, 21453 (Closed treatment of mandibular fracture with interdental fixation). If it was for the stabilization of a LeFort I maxillary fracture, you will report it with 21421 (Closed treatment of palatal or maxillary fracture [LeFort I type], with interdental wire fixation or fixation of denture or splint).

On the other hand, if your clinician used the fixation for some treatment other than fracture, you will have to report it with the CPT® code, 21497 (Interdental wiring, for condition other than fracture).