Overview of CPT Code 21145: Mandibular Osteotomy
Mandibular osteotomy is a surgical procedure that involves cutting and repositioning the lower jaw (mandible) to correct various dental and facial deformities.
When CPT Code 21145 is Used?
This procedure is indicated in several clinical scenarios.
- Severe malocclusion due to skeletal discrepancies.
- Facial asymmetry requiring correction.
- Reconstruction after trauma or tumor removal.
- Improvement of airway obstruction related to jaw position.
Symptoms Indicating This Procedure
Patients may report various symptoms that lead to the consideration of this surgery.
- Difficulty chewing or biting.
- Chronic jaw pain or discomfort.
- Facial asymmetry or deformity.
- Speech difficulties related to jaw position.
Causes and Risk Factors
Several factors can contribute to the need for a mandibular osteotomy.
- Genetic conditions affecting jaw development.
- Trauma to the jaw or face.
- Tumors affecting the mandible.
- Previous orthodontic treatment that did not achieve desired results.
Diagnostic Tests Before Procedure
Several diagnostic tests are performed to evaluate the need for surgery.
- Panoramic X-rays to assess jaw structure.
- CT scans for detailed imaging of the mandible.
- Cephalometric analysis for orthodontic evaluation.
- Dental impressions for planning.
Procedure Description
The surgical procedure involves several key steps.
- Administer anesthesia to ensure patient comfort.
- Make incisions in the gum tissue to access the mandible.
- Cut the mandible at specific locations to allow for repositioning.
- Reposition the mandible to the desired location.
- Secure the mandible using plates and screws.
- Close the incisions with sutures.
Preparation for the Procedure
Patients should follow specific guidelines before surgery.
- Consult with the surgeon about medications to avoid.
- Arrange for transportation to and from the surgery.
- Follow dietary restrictions as advised, including fasting.
- Discuss any allergies or medical conditions with the healthcare team.
Recovery and Aftercare
Post-operative care is crucial for recovery.
- Expect swelling and bruising for several days.
- Follow a soft diet to avoid strain on the jaw.
- Take prescribed pain medications as needed.
- Attend follow-up appointments for suture removal and monitoring.
Possible Complications
As with any surgery, there are potential risks involved.
- Infection at the surgical site.
- Nerve damage leading to numbness.
- Non-union of the bone segments.
- Changes in bite or occlusion.
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Post-Procedure Follow-Up
Regular follow-up is essential for monitoring recovery.
- Initial follow-up within one week post-surgery.
- Subsequent visits at one month and three months.
- Long-term follow-up may be necessary for orthodontic adjustments.
Alternative Treatments
Non-surgical options may be considered in some cases.
- Orthodontic treatment to realign teeth.
- Dental appliances to improve bite.
- Physical therapy for jaw pain management.
Home Care Tips
Patients can take steps to aid their recovery at home.
- Apply ice packs to reduce swelling.
- Maintain oral hygiene with gentle brushing.
- Stay hydrated and eat soft foods.
- Avoid strenuous activities during recovery.
Patient Education & Prevention
Understanding the condition can help prevent recurrence.
- Regular dental check-ups to monitor jaw health.
- Early intervention for orthodontic issues.
- Awareness of symptoms that may indicate jaw problems.
Billing and Coding Information
CPT Code: 21145
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on several factors.
- Average cost ranges from $5,000 to $15,000.
- Insurance may cover part or all of the procedure.
- Pre-authorization may be required for coverage.
Related CPT Codes
- 21146 - Injection of Bone Graft, Mandible
- 21147 - Excision of benign skin lesion, face, ears, scalp, neck
References and Sources
Frequently Asked Questions (FAQs)
What is a mandibular osteotomy?
It is a surgical procedure to correct jaw alignment.
How long is the recovery period?
Recovery typically takes several weeks.
Will I need braces after surgery?
Orthodontic treatment may be necessary for optimal results.
