CPT® Code 21182

Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm

The procedure described by CPT® Code 21182 involves the surgical reconstruction of the orbital walls, rims, forehead, and nasoethmoid complex following the excision of benign tumors from the cranial bone, such as fibrous dysplasia. This complex surgical intervention is performed under general anesthesia and requires the physician to create various incisions, which may include those in the eyelid and scalp, to access the affected areas. The excision of the tumors is carried out using both intra- and extracranial approaches, ensuring complete removal of the tumor tissue. Following the excision, the bones in the affected areas are carefully fractured and repositioned to restore their proper anatomical alignment. To facilitate this reconstruction, multiple autografts are harvested from the patient's own body, typically from the hip, rib, or skull. These grafts are then inserted into the surgical site to augment and stabilize the areas where the tumors have been removed. The use of fixation devices, such as wires, plates, and screws, is essential to maintain the structural integrity and shape of the facial bones during the healing process. The incisions made during the procedure are meticulously closed in layers to promote optimal healing and minimize scarring. It is important to note that this code is applicable when the total area of bone grafting is less than 40 square centimeters, distinguishing it from other related codes that apply to larger grafting areas.