CPT® Code 21247

Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)

The procedure described by CPT® Code 21247 involves the reconstruction of the mandibular condyle using autografts of bone and cartilage. This surgical intervention is typically indicated for conditions such as hemifacial microsomia, where there is an underdevelopment of the facial structures, particularly affecting the jaw and its articulation with the skull. During the procedure, the surgeon harvests bone and cartilage grafts, often sourced from the patient's ribs, to ensure compatibility and reduce the risk of rejection. The surgical approach usually requires an incision made near or within the ear, allowing access to the temporomandibular joint (TMJ). Once the joint is accessed, it is carefully isolated and exposed to facilitate the insertion of the graft. The graft, which consists of both bone and cartilage, is strategically placed into the recipient site, with the cartilaginous portion serving to replace the condyle. To secure the graft in place, the surgeon employs fixation methods such as screws, wires, and metal plates, ensuring stability and proper alignment. Finally, the incisions made during the procedure are meticulously closed to promote healing and minimize scarring.