CPT® Code 21159

Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I

The procedure described by CPT® Code 21159 involves the reconstruction of the midface using a LeFort III osteotomy, which is a surgical technique aimed at correcting facial deformities. This specific procedure is performed without the inclusion of a LeFort I osteotomy, focusing instead on the midfacial region and the cranial base. The surgery is conducted under general anesthesia, ensuring that the patient is fully unconscious and pain-free throughout the operation. The physician makes several incisions in strategic locations, such as transoral (inside the mouth), lower eyelid, and scalp, to access the midfacial bones effectively. During the procedure, the midfacial bones are carefully manipulated and completely detached from the cranial base, allowing for precise repositioning. The surgeon then inserts bone grafts into designated areas to support the new structure of the midface. Various surgical instruments, including osteotomes, saws, and burs, are utilized to reshape and correct any irregularities in the bone structure. To secure the repositioned bones, fixation devices such as plates, screws, and wires are employed. An antibiotic solution is applied to minimize the risk of infection, and the incisions are meticulously closed at the end of the procedure. In some cases, intermaxillary fixation may be required to stabilize the jaw and ensure proper alignment during the healing process.