Overview of CPT Code 21365: Repair of zygomatic arch fracture
CPT Code 21365 refers to the surgical repair of a fracture in the zygomatic arch, which is a key structure in the facial skeleton that contributes to the prominence of the cheek.
When CPT Code 21365 is Used?
This procedure is indicated in specific clinical scenarios.
- Significant displacement of the zygomatic arch due to trauma.
- Facial asymmetry caused by zygomatic arch fractures.
- Inability to achieve proper occlusion or dental alignment due to zygomatic arch injury.
- Fractures associated with other facial injuries requiring surgical intervention.
Symptoms Indicating This Procedure
Patients may present with various symptoms that suggest the need for surgical repair.
- Visible deformity or asymmetry of the face.
- Pain and tenderness in the cheek area.
- Swelling and bruising around the eyes and cheeks.
- Difficulty in chewing or biting due to misalignment.
Causes and Risk Factors
Understanding the causes and risk factors can help in prevention.
- Motor vehicle accidents leading to facial trauma.
- Sports injuries, particularly in contact sports.
- Falls resulting in facial impact.
- Assaults or physical altercations.
Diagnostic Tests Before Procedure
Several diagnostic tests are essential for accurate assessment.
- CT scan of the facial bones to evaluate the extent of the fracture.
- X-rays to confirm the presence of a fracture.
- Facial imaging to assess soft tissue involvement.
Procedure Description
The surgical procedure involves several key steps.
- Administer anesthesia to ensure patient comfort.
- Make an incision in the oral cavity or through the skin near the fracture site.
- Access the zygomatic arch and realign the fractured segments.
- Use plates, screws, or wires to stabilize the fracture.
- Close the incision with sutures and apply a dressing.
Preparation for the Procedure
Proper preparation is crucial for a successful outcome.
- Avoid eating or drinking for at least 8 hours before surgery.
- Discuss any medications with your doctor, especially blood thinners.
- Arrange for transportation to and from the surgical facility.
- Follow any specific instructions provided by your healthcare team.
Recovery and Aftercare
Post-operative care is vital for healing.
- Expect swelling and bruising, which should gradually improve.
- Use ice packs to reduce swelling in the first 48 hours.
- Take prescribed pain medications as directed.
- Avoid strenuous activities for several weeks.
Possible Complications
While complications are rare, they can occur.
- Infection at the surgical site.
- Nerve damage leading to altered sensation.
- Nonunion or malunion of the fracture.
- Persistent pain or discomfort.
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Post-Procedure Follow-Up
Regular follow-up is essential for monitoring recovery.
- Schedule a follow-up appointment within 1-2 weeks post-surgery.
- Monitor for signs of infection or complications.
- Assess healing through imaging if necessary.
Alternative Treatments
In some cases, non-surgical options may be considered.
- Observation for non-displaced fractures.
- Pain management with medications.
- Physical therapy to improve function and mobility.
Home Care Tips
Simple home care can aid in recovery.
- Keep the surgical area clean and dry.
- Follow a soft diet to avoid strain on the jaw.
- Stay hydrated and rest adequately.
Patient Education & Prevention
Education can help prevent future injuries.
- Wear protective gear during sports.
- Use seat belts in vehicles.
- Be cautious in high-risk environments to prevent falls.
Billing and Coding Information
CPT Code: 21365
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 a significant portion, depending on the plan.
- Pre-authorization may be required for coverage.
Related CPT Codes
- 21310 - Excision of benign lesion, face, ears, scalp, neck
- 21320 - Excision of benign skin lesion, face, ears, scalp, neck
- 21335 - Excision of benign skin lesion, face, ears, scalp, neck
- 21355 - Excision of benign skin lesion, face, ears, scalp
References and Sources
Frequently Asked Questions (FAQs)
What is a zygomatic arch fracture?
A zygomatic arch fracture is a break in the bone that forms the cheekbone area.
How long is the recovery period?
Recovery typically takes several weeks, depending on the severity of the fracture.
Will I have scars after surgery?
Incisions are often made inside the mouth or in inconspicuous areas to minimize scarring.
What can I do to manage pain after surgery?
Your doctor will prescribe pain medications to help manage discomfort.
