Overview of CPT Code 21247: Injection of bone cement into the maxilla or mandible

Overview of CPT Code 21247: Injection of bone cement into the maxilla or mandible

CPT Code 21247 refers to the procedure of injecting bone cement into the maxilla or mandible, typically used to stabilize fractures or defects in the jawbone.

When CPT Code 21247 is Used?

This procedure is indicated in various clinical scenarios.

• Management of osteoporotic fractures in the maxilla or mandible.
• Stabilization of bone defects due to tumors or cysts.
• Repair of fractures resulting from trauma.
• Support for dental implants in cases of insufficient bone density.

Symptoms Indicating This Procedure

Patients may present with several symptoms that warrant this procedure.

• Pain in the jaw area.
• Swelling or deformity of the jaw.
• Difficulty chewing or speaking.
• Visible fractures or instability in the jawbone.

Causes and Risk Factors

Several factors can contribute to the need for this procedure.

• Osteoporosis leading to weakened bone structure.
• Traumatic injuries to the jaw.
• Presence of tumors or cysts in the jawbone.
• Previous dental procedures that may compromise bone integrity.

Diagnostic Tests Before Procedure

Certain tests are essential to evaluate the condition of the jawbone.

• X-rays to assess bone integrity and fractures.
• CT scans for detailed imaging of the jaw structure.
• MRI to evaluate soft tissue involvement.
• Bone density tests to assess osteoporosis.

Procedure Description

The procedure involves several key steps.

• Patient is positioned comfortably and local anesthesia is administered.
• An incision may be made in the gum tissue to access the bone.
• The area is prepared, and bone cement is mixed according to manufacturer instructions.
• The bone cement is injected into the targeted area of the maxilla or mandible.
• The incision is closed with sutures, and the area is cleaned.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Avoid eating or drinking for at least 6 hours prior to the procedure.
• Inform the healthcare provider of any medications being taken.
• Arrange for transportation home post-procedure.
• Discuss any allergies or previous reactions to anesthesia.

Recovery and Aftercare

Post-procedure care is crucial for recovery.

• Rest for the first 24 hours after the procedure.
• Apply ice packs to reduce swelling.
• Take prescribed pain medications as directed.
• Follow up with the healthcare provider for suture removal and assessment.

Possible Complications

While generally safe, there are potential risks involved.

• Infection at the injection site.
• Allergic reaction to the bone cement.
• Nerve damage leading to numbness or tingling.
• Failure of the cement to properly stabilize the bone.

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Post-Procedure Follow-Up

Regular follow-up is essential for monitoring recovery.

• Initial follow-up within 1 week to assess healing.
• Subsequent visits at 1 month and 3 months post-procedure.
• Additional imaging may be required to evaluate the success of the procedure.

Alternative Treatments

There are non-surgical options available.

• Physical therapy to strengthen jaw muscles.
• Medications for pain management.
• Bone grafting procedures to enhance bone density.
• Use of dental implants without cement injection in certain cases.

Home Care Tips

Patients can take steps to aid their recovery at home.

• Maintain good oral hygiene to prevent infection.
• Avoid hard or chewy foods for a few days.
• Stay hydrated and eat soft foods.
• Monitor for any signs of complications and contact the provider if necessary.

Patient Education & Prevention

Education is key to preventing future issues.

• Understand the importance of bone health and nutrition.
• Engage in weight-bearing exercises to strengthen bones.
• Regular dental check-ups to monitor jaw health.
• Avoid tobacco use which can impair healing.

Billing and Coding Information

CPT Code: 21247

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• LT - Left side
• RT - Right side

Average Cost and Insurance Coverage

Costs can vary based on several factors.

• Average cost ranges from $1,500 to $3,000.
• Insurance may cover the procedure if deemed medically necessary.
• Out-of-pocket costs depend on the patient's insurance plan.

Related CPT Codes

• 21245 - Injection of bone cement into vertebral body
• 21248 - Injection of implantable drug delivery system, craniofacial
• 21246 - Injection of implantable drug delivery device, craniofacial region

References and Sources

• American Academy of Oral and Maxillofacial Surgeons
• National Institutes of Health - Bone Health