CPT® Code 21146

Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)

The procedure described by CPT® Code 21146 involves the reconstruction of the midface using a LeFort I osteotomy technique, which is specifically designed for patients with facial bone deformities or for cosmetic enhancements. This surgical intervention is characterized by the movement of two segments of the maxilla, which is the upper jawbone, and it necessitates the use of bone grafts. Bone grafts may be obtained from the patient's own body (autografts), particularly in cases such as ungrafted unilateral alveolar clefts, where there is a need to restore the structural integrity of the midface. The LeFort I osteotomy focuses on the lower maxillary region, which is anatomically defined as the area below the infraorbital nerve and medial to the zygomatic-maxillary suture. The procedure is comprehensive, involving the extraction of premolars and last molars as necessary, careful tunneling of the palatal mucosa to avoid tissue damage, and precise incisions to access the nasal cavity and maxilla. The surgical steps are meticulously planned and executed to ensure proper alignment and stabilization of the maxilla, ultimately aiming to improve both function and aesthetics for the patient.