CPT® Code 21423

Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), multiple approaches

The CPT® Code 21423 refers to the open treatment of a palatal or maxillary fracture classified as a LeFort I type. This type of fracture can be complicated, meaning it may be comminuted, which indicates that the bone is broken into several pieces, or it may involve the cranial nerve foramina, which are openings in the skull that allow cranial nerves to pass through. The procedure is performed using multiple approaches, specifically intraoral and lower eyelid approaches, to provide optimal visualization and access to the fracture site. During the procedure, the physician carefully repositions the maxilla, which is the upper jawbone, and stabilizes it using various fixation methods such as screws, plates, or wires. Additionally, if the infraorbital nerve, which is responsible for sensation in the face, is affected, the physician may need to reposition it, potentially requiring bone grafting to provide adequate support for the nerve. After the necessary adjustments and repairs are made, all incisions are meticulously closed. To ensure proper stabilization of the maxilla during the healing process, the physician may also utilize a customized palatal splint or an intermaxillary device.