Wiki Orbital Medpor Graft

pegjoh5746

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I'm looking for some advice. One of our oculoplastics providers previously performed an orbital floor fracture blowout repair. The patient is now having a medpor graft placed under the previous repair to improve enophthalmia. The bone is not being drilled and the previous graft is not being removed. The new graft is just reinforcing the previous surgery to move the eye into a better position. I'm wondering if 21208 would cover this the procedure. Any suggestions would be helpful.
 
This is the lay description for 21208. Does it fit?
The physician augments the facial bones with implanted grafts or prosthetic devices, altering the contours of the face. The physician may use an intraoral approach or other incisions to access the operative site. The tissue is dissected, exposing the bone for augmentation. A bone graft is taken from another part of the body, such as the hip, rib, or skull, and grafted onto the facial bone to contour the face. Other materials such as prosthetic implants or donor bone may also be used. The implant is secured to the bone using screws, wires, or plates. The mucosa is sutured simply.
 
I guess another question could be is this still in the global for the initial fracture surgery? It may be worth taking a look at fracture codes if that is the case with a 78 modifier. Maybe a 52 with a 21390, or even just 21390 straight out? Just a thought depending on if the fracture is still healing.
 
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