{"id":179918,"date":"2026-08-14T08:05:02","date_gmt":"2026-08-14T08:05:02","guid":{"rendered":"https:\/\/pabau.com\/?p=179918"},"modified":"2026-08-14T08:05:04","modified_gmt":"2026-08-14T08:05:04","slug":"cpt-code-21343","status":"publish","type":"post","link":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/","title":{"rendered":"CPT Code 21343: Open treatment of depressed frontal sinus fracture"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 21343: Open treatment of depressed frontal sinus fracture\",\"description\":\"Complete billing reference for CPT Code 21343 (open treatment of depressed frontal sinus fracture): descriptor, RVU values, global period, Medicare reimbursement, modifiers, ICD-10 pairings, and related codes 21340, 21344, and 21345.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21343\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-10\",\"dateModified\":\"2026-08-14\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT Code 21343 covers open treatment of a depressed frontal sinus fracture, reported under the head fracture and dislocation subsection.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The global period is 090 days, so routine postoperative care for three months is bundled into the surgical fee.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Facility and non-facility RVU values differ, so check current work RVU figures against the CMS Physician Fee Schedule before billing.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The operative note decides between 21343 and 21344, since posterior table repair or cranialization moves the case to 21344.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau links CPT selection to the treatment record, so coders and surgeons work from one document.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT Code 21343 is the billable code for open treatment of a depressed frontal sinus fracture. It covers surgical access to the fracture site, elevation of the depressed bone fragments, and stabilization of the anterior table. Coders reach for it when facial trauma goes to the operating room without documented intracranial involvement.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This reference covers the official descriptor, RVU structure, global period, Medicare reimbursement, modifiers, and the ICD-10 codes that support medical necessity. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It also compares 21343 with 21340, 21344, and 21345, the adjacent codes coders most often confuse it with. <a href=\"https:\/\/pabau.com\/industry\/plastic-surgery-emr\/\">Plastic surgery practices<\/a> and oral and maxillofacial groups bill this code from trauma referrals.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The American Medical Association (AMA) maintains the CPT code set and classifies 21343 as major surgery. A clean claim needs the right supporting ICD-10 diagnosis, accurate modifiers, and an operative note confirming open access, reduction, and stabilization.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-cpt-code-21343-description-and-clinical-context\" class=\"wp-block-heading\">CPT Code 21343: Description and clinical context<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 21343 carries the following official descriptors as published in the AMA CPT manual:<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Value<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21343<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Short descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment dprsd front sinus<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Long descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of depressed frontal sinus fracture<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code section<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Musculoskeletal System: Fracture and\/or Dislocation Procedures on the Head<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code range<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21315-21497<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Global period<\/td>\n<td style=\"padding:12px 16px;color:#374151\">090 days<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">In lay terms, the surgeon makes an incision to reach a frontal sinus fracture where bone fragments have been pushed inward. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The physician then elevates or repositions the displaced bone, stabilizes the fragments, and repairs the anterior or posterior table as needed. Open treatment means surgical access to the fracture site, not manipulation from outside the skin surface.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The frontal sinus sits behind the forehead, between the outer and inner tables of the skull. Depressed fractures here carry a risk of intracranial involvement and dural injury. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That risk is why the choice between 21343 and 21344 rests on a careful read of the operative report. When no intracranial injury or significant dural disruption is documented, 21343 is usually the right code.<\/p>\n\n\n\n<h2 id=\"h-what-the-procedure-involves\" class=\"wp-block-heading\">What the procedure involves<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Before billing CPT Code 21343, confirm the operative note reflects each of these stages. A note that records the fracture diagnosis without confirming open access and fragment reduction will not support the code on audit.<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Surgical access:<\/strong> Typically via a coronal, bicoronal, or existing laceration approach, exposing the frontal sinus anterior table.<\/li>\n\n\n\n<li><strong>Fracture identification:<\/strong> Direct visualization confirms the location and degree of fragment depression.<\/li>\n\n\n\n<li><strong>Fracture reduction:<\/strong> Displaced fragments are elevated and repositioned to restore normal contour. Devitalized fragments may be removed.<\/li>\n\n\n\n<li><strong>Stabilization:<\/strong> Fragments are fixed with plates, screws, wires, or sutures, depending on the fracture pattern.<\/li>\n\n\n\n<li><strong>Sinus management:<\/strong> The surgeon may obliterate the sinus with fat or cranialize it. Significant posterior table injury usually shifts the case to 21344.<\/li>\n\n\n\n<li><strong>Wound closure:<\/strong> Layered closure of the access incision, with hemostasis documented.<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\">The American Association of Oral and Maxillofacial Surgeons publishes a Trauma Coding Paper that references 21343 for frontal sinus repair. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Coders in oral, maxillofacial, or head and neck surgery can treat it as a specialty companion to the AMA CPT manual. It also answers common sequencing questions about facial fracture repairs billed alongside 21343.<\/p>\n\n\n\n<h2 id=\"h-rvu-values-and-what-they-cover\" class=\"wp-block-heading\">RVU values and what they cover<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Relative Value Units (RVUs) drive the base reimbursement calculation under the Medicare Physician Fee Schedule (MPFS). The <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU 2026 lookup tool<\/a> and the CMS MPFS data files are the most reliable sources for current figures. RVUs are adjusted every year, so check the current fiscal year before billing.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">RVU component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:center;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Applies to<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Work RVU (wRVU)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Reflects physician time, skill, and intensity for the procedure<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">All settings<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Practice expense RVU (facility)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Lower value when the procedure is performed in a hospital or ASC, where the facility absorbs overhead<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Facility only<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Practice expense RVU (non-facility)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Higher value when performed in a physician office, where the practice absorbs overhead costs<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Non-facility only<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Malpractice RVU (MP)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Reflects malpractice insurance cost attributed to the procedure<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">All settings<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU (facility)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Work RVU plus facility practice expense RVU plus malpractice RVU, multiplied by the conversion factor<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Facility<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU (non-facility)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same calculation using the non-facility practice expense RVU, which gives a higher total<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">Non-facility<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Because 21343 is major surgery, the facility rate applies in almost every billing scenario. Open frontal sinus repair needs an operating room, which means a hospital or an ambulatory surgery center. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The non-facility rate applies only in the rare case of an office-based operating room. Record the place of service accurately so the payer applies the correct RVU tier.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Check CPT Code 21343 RVU values in the CMS Physician Fee Schedule Look-Up Tool at the start of each calendar year. AMA and CMS publish RVU updates annually, and reusing a prior-year value can lead to under- or overbilling.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-global-period-and-surgical-package-inclusions\" class=\"wp-block-heading\">Global period and surgical package inclusions<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 21343 carries a 090-day global period under the Medicare global surgical package policy. That matches the CMS standard for major surgery. Medicare and most commercial payers bundle the following services into the single surgical fee, with no separate payment during the global window:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The surgical procedure itself on the date of service<\/li>\n\n\n\n<li>All intraoperative services considered part of the procedure<\/li>\n\n\n\n<li>Routine postoperative visits for 90 days after the surgery date<\/li>\n\n\n\n<li>Complications that do not require a return to the operating room<\/li>\n\n\n\n<li>Postoperative pain management considered routine for this procedure<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Some services sit outside the package and can be billed separately:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A significant, separately identifiable evaluation and management (E\/M) visit on the day of or the day before surgery<\/li>\n\n\n\n<li>A return to the operating room for complications<\/li>\n\n\n\n<li>An unrelated procedure performed during the global period<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Append modifier -25 to the qualifying E\/M code and document medical necessity clearly.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Payers flag these claims for medical review more often than they used to. Surgical trauma cases draw extra attention, because follow-up visits are expected to be frequent. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Hand the patient a structured <a href=\"https:\/\/pabau.com\/templates\/patient-discharge-form\/\">patient discharge form<\/a> at the end of the surgical visit. It records the postoperative plan and dates the start of the 90-day window.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices managing <a href=\"https:\/\/pabau.com\/blog\/opening-a-cosmetic-surgery-clinic\/\">reconstructive surgery workflows<\/a> should flag when each patient&#8217;s 90-day global window expires. Billing a follow-up visit inside the global period without a qualifying modifier is one of the most common audit recoveries in surgical practices.<\/p>\n\n\n\n<h2 id=\"h-medicare-reimbursement-and-fee-schedule\" class=\"wp-block-heading\">Medicare reimbursement and fee schedule<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare payment for CPT Code 21343 starts with the total RVU multiplied by the annual conversion factor. That figure is then adjusted for the Geographic Practice Cost Index (GPCI) of the provider&#8217;s locality. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule lookup tool<\/a> searches current allowed amounts by locality and place of service. Geographic adjustment varies widely, so a metropolitan practice and a rural one are paid different amounts for the same code.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Key reimbursement considerations for 21343 claims:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Facility vs. non-facility rate:<\/strong> Hospital and ASC claims pay the lower facility rate for the professional component. The facility bills its own fees separately.<\/li>\n\n\n\n<li><strong>Annual MPFS updates:<\/strong> CMS updates the conversion factor and GPCI values each January 1. Check rates at the start of each year.<\/li>\n\n\n\n<li><strong>Commercial payers:<\/strong> Private rates usually reference the MPFS but apply contracted multipliers. Check your contracts for the applicable percentage of Medicare.<\/li>\n\n\n\n<li><strong>Medicare Administrative Contractors:<\/strong> Regional MACs publish local coverage determinations that affect which ICD-10 diagnoses support medical necessity. Confirm your MAC&#8217;s policy before billing.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau tracks reimbursement outcomes by CPT code, so procedure documentation and payment data sit in one platform. Pabau&#8217;s <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> keeps that reporting in the same system your team already documents in, with no separate export.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-21343\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s claims tools submit and track surgical claims from the same record that holds the operative note.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 id=\"h-modifiers-that-apply-to-21343\" class=\"wp-block-heading\">Modifiers that apply to 21343<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection for 21343 follows standard CMS National Correct Coding Initiative rules. Incorrect modifiers are among the most common reasons surgical claims are rejected. The table below covers the modifiers that apply most often to this code:<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Name<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use it with 21343<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-22<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Increased procedural services<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When the procedure takes substantially more work than usual. The documentation must quantify the added time or complexity.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-51<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When 21343 is performed with other procedures in the same session. The lower-value code takes the payment reduction.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-62<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Two surgeons<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When two surgeons of different specialties each perform a distinct part of the procedure. Both append -62 to 21343.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-80<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Assistant surgeon<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Used by the assisting surgeon billing for services provided during the primary surgeon&#8217;s procedure.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-LT \/ -RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left side \/ right side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Frontal sinuses are paired, so some payers require a laterality modifier when the fracture is unilateral.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-25<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Significant, separately identifiable E\/M<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Applied to a documented E\/M visit on the day of surgery that goes beyond the decision for surgery.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier -22 needs the most careful documentation. Writing \u00abcomplex case\u00bb in the operative note is not enough. The note has to name what pushed the case beyond the usual, such as severe comminution, a sinus obliteration decision, or scarring from previous surgery. Payers increasingly ask for a written explanation before they process a claim carrying -22.<\/p>\n\n\n\n<h2 id=\"h-icd-10-codes-that-support-medical-necessity\" class=\"wp-block-heading\">ICD-10 codes that support medical necessity<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Pairing 21343 with an unsupported ICD-10 diagnosis is a fast route to a medical necessity denial. The codes below are commonly accepted as supporting open treatment of a depressed frontal sinus fracture. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Local determinations vary, so check coverage against your MAC and your payer&#8217;s policies. Head trauma often carries a companion diagnosis, and codes such as <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s066x1d\/\">S06.6X1D<\/a> can appear on the same claim.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S02.19XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of other specified skull and facial bones, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use 7th character A for the initial encounter, D for subsequent, S for sequela<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S02.19XB<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of other specified skull and facial bones, initial encounter for open fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use when the fracture is open or compound<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S02.0XXA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of vault of skull, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">May apply when frontal bone involvement extends to the skull vault<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S02.0XXB<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of vault of skull, initial encounter for open fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open fracture variant, so confirm the wound documentation supports it<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S09.90XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified injury of head, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use as a secondary code when no specific skull fracture code fits<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The 7th character extension is mandatory on every ICD-10-CM injury code. Claims submitted without it are usually rejected at the clearinghouse. The initial surgical encounter takes \u00abA\u00bb, and follow-up visits inside the global period take \u00abD\u00bb. Sequela coding with \u00abS\u00bb applies when a late effect of the fracture is treated after healing is complete.<\/p>\n\n\n\n<h2 id=\"h-documentation-requirements-and-coding-tips\" class=\"wp-block-heading\">Documentation requirements and coding tips<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Operative note completeness decides whether 21343 survives a retrospective audit. Many of these fractures arrive by referral from emergency departments or <a href=\"https:\/\/pabau.com\/industry\/sports-medicine-software\/\">sports medicine practices<\/a>, so the imaging predates the surgical visit. Reference that scan by date in the note. Do not submit 21343 until the report documents each of the following:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fracture confirmation:<\/strong> A head or facial CT scan referenced in the note, confirming a depressed frontal sinus fracture.<\/li>\n\n\n\n<li><strong>Surgical access:<\/strong> The incision approach used, and the extent of exposure achieved.<\/li>\n\n\n\n<li><strong>Fracture treatment:<\/strong> The reduction technique, fragment management, and stabilization method, including hardware type or obliteration materials.<\/li>\n\n\n\n<li><strong>Sinus involvement:<\/strong> Whether the anterior table alone was addressed, or the posterior table as well.<\/li>\n\n\n\n<li><strong>Surgeon identity:<\/strong> With modifier -62, both surgeons&#8217; roles documented in separate reports or co-signed sections.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Three denial triggers account for most 21343 rejections. The first is submitting the code with no CT imaging referenced in the note. The second is billing 21343 when the documentation actually describes 21344 criteria. The third is a missing 7th character on the ICD-10 code.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Keeping <a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-for-medical-offices\/\">HIPAA-compliant documentation practices<\/a> satisfies the regulator and builds an audit-ready record at the same time, which cuts claim review time. <a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">Digital operative note templates<\/a> in your practice management system capture the mandatory fields before a case is closed.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-21343\/digital-forms.webp\" alt=\"Digital forms in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s digital forms turn the operative note into required fields, so no imaging reference or fixation detail is left blank.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 id=\"h-related-cpt-codes-21340-21344-and-21345\" class=\"wp-block-heading\">Related CPT codes: 21340, 21344, and 21345<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 21343 sits in a cluster of codes covering different approaches and complexity levels for facial fracture repair. The <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC Codify CPT lookup<\/a> and the AMA CPT manual are the authoritative references for comparing descriptors. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Open fracture codes elsewhere in the musculoskeletal chapter, such as <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-22318\/\">22318<\/a>, follow the same open-versus-closed logic.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Descriptor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key distinction from 21343<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21340<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Percutaneous treatment of nasoorbitoethmoid complex fracture, with splint, wire, or interdental fixation, when performed<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Percutaneous approach with no surgical opening of the fracture site. Different anatomical site, the nasoorbitoethmoid complex.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21343<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of depressed frontal sinus fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The reference code. Open access to the frontal sinus, with no documented brain injury or complex dural repair.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21344<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Higher complexity, covering posterior table involvement, severe comminution, or associated intracranial procedures. Higher RVU than 21343.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21345<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Closed treatment of nasomaxillary complex fracture (LeFort type II), with interdental fixation<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A different fracture pattern at the nasal-maxillary junction, not the frontal sinus. Closed approach with fixation.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The distinction between 21343 and 21344 is the one that moves money. If the operative report documents posterior table involvement with significant dural repair, brain injury management, or sinus cranialization, the case has crossed into 21344. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Upcoding to 21344 without that documentation is an audit risk. Downcoding a 21344 case to 21343 costs the practice reimbursement it has earned.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Before assigning 21343 or 21344, ask one question. Does the operative report describe posterior table repair, sinus cranialization, or intracranial access? If it does, review the 21344 criteria. If the repair stayed on the anterior table with standard fragment reduction, 21343 is the right code.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-how-pabau-supports-accurate-cpt-billing\" class=\"wp-block-heading\">How Pabau supports accurate CPT billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Standalone code lookup tools make billing staff leave the practice management system, find a code, and re-enter it on the claim. Every handoff is a chance to mistype something. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau puts procedure code selection inside the clinical documentation workflow instead. Surgeons confirm the CPT code while documenting the treatment, and billing staff work from that same record.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For surgical codes like 21343, that matters most at the modifier and ICD-10 pairing level. The <a href=\"https:\/\/pabau.com\/features\/medical-records-management\/\">patient record management<\/a> tools keep operative documentation, diagnosis codes, and billing codes linked in one record. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A claim is far less likely to go out with the wrong 7th character or a missing modifier. <a href=\"https:\/\/pabau.com\/blog\/plastic-surgery-practice-emr-software\/\">Software for plastic surgeons<\/a> earns its place here because surgical billing lives or dies by the operative note.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau also reports at procedure level. A billing manager can see how often 21343 is billed, what average reimbursement looks like, and where claims are denied. None of that needs an export to a separate analytics tool. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Those numbers show whether a documentation pattern is driving denials before a payer opens a formal review. Among <a href=\"https:\/\/pabau.com\/blog\/best-plastic-surgery-software\/\">surgical practice management tools<\/a>, that closed loop is what turns a denial trend into something you catch early.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-21343\/comprehensive-emr-patient-record-management.webp\" alt=\"Comprehensive EMR and patient record management in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s EMR holds the operative note, the ICD-10 pairing, and the CPT code in one record, so an audit request is a single lookup.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Reduce billing errors in your surgical practice                <\/h3>\n\n                <p class=\"description\">\n                    Pabau puts CPT code selection inside the treatment record, so surgeons and billing staff work from the same documentation. Track global periods, store operative notes, and send cleaner claims.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau practice management dashboard for surgical practices\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">21343 is a narrow code, and the operative note is what keeps it defensible. Write the note so a reviewer can see open access, the reduction, the fixation, and which sinus table was treated. Choose the code after that, never before.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The trade-off worth remembering sits between 21343 and 21344. Reaching for the higher code without posterior table documentation invites recoupment. Staying with 21343 on a case that clearly crossed the line gives away money the practice has already earned. One line in the operative report settles it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Keeping the note, the diagnosis, and the code in one linked record is what makes that judgment quick instead of a scavenger hunt. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau handles frontal sinus fracture billing from operative note to submitted claim.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing another plastic surgery procedure?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-19324\/\">19324<\/a> covers the descriptor, documentation requirements, and denial triggers for that code.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Coding a head injury alongside the fracture?<\/strong> <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s062x2d\/\">S06.2X2D<\/a> explains the encounter characters and the documentation each one needs.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Tracking recovery after facial trauma surgery?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/neurological-vital-signs\/\">Neurological vital signs<\/a> sets out what to record at each postoperative check.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Checking for orbital involvement after facial trauma?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/neurological-eye-exam\/\">Neurological eye exam<\/a> walks through the bedside assessment step by step.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786626569193\"><h3 class=\"schema-faq-question\">What is CPT Code 21343 used for?<\/h3> <p class=\"schema-faq-answer\">CPT Code 21343 bills open surgical treatment of a depressed frontal sinus fracture. The procedure covers surgical access to the fracture site, reduction of displaced bone fragments, and stabilization of the anterior table. It sits in the Musculoskeletal System&#8217;s Fracture and\/or Dislocation Procedures on the Head subsection of the AMA CPT manual.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786626569194\"><h3 class=\"schema-faq-question\">What is the global period for CPT 21343?<\/h3> <p class=\"schema-faq-answer\">The global period is 090 days, which classifies 21343 as major surgery under CMS guidelines. Every routine postoperative visit within 90 days of surgery is bundled into the surgical fee. Services outside the package can be billed separately with the right documentation and modifier. Those include a return to the operating room and an unrelated procedure.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786626569195\"><h3 class=\"schema-faq-question\">How does CPT 21343 differ from CPT 21344?<\/h3> <p class=\"schema-faq-answer\">CPT 21343 covers open treatment of a depressed frontal sinus fracture limited to the anterior table, with no complex intracranial involvement. CPT 21344 describes a more complex repair involving the posterior wall, severe comminution, or a coronal or multiple-approach access. The operative report decides it: posterior table repair or intracranial access moves the case from 21343 to 21344.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786626569196\"><h3 class=\"schema-faq-question\">Which ICD-10 codes support medical necessity for CPT 21343?<\/h3> <p class=\"schema-faq-answer\">The codes paired most often are S02.19XA for a closed fracture of other specified skull and facial bones, and S02.19XB for the open fracture equivalent. S02.0XXA and S02.0XXB apply when frontal bone involvement extends to the skull vault. Every injury code needs the correct 7th character: A for the initial encounter, D for subsequent, and S for sequela. Check pairing acceptability against your MAC&#8217;s local coverage determination.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786626569197\"><h3 class=\"schema-faq-question\">What is the Medicare reimbursement rate for CPT 21343?<\/h3> <p class=\"schema-faq-answer\">Medicare reimbursement is the total RVU multiplied by the annual CMS conversion factor, adjusted for the provider&#8217;s Geographic Practice Cost Index locality. Geographic adjustment varies widely across the United States, so the allowed amount differs by location. Use the CMS Physician Fee Schedule Look-Up Tool to pull current rates by place of service and locality before billing.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786626569198\"><h3 class=\"schema-faq-question\">What documentation is required when billing CPT Code 21343?<\/h3> <p class=\"schema-faq-answer\">The operative report must record the supporting CT imaging, the surgical access approach, the reduction and stabilization technique, and the extent of sinus table involvement. It also has to identify the surgeon, and both surgeons when modifier -62 is appended. With modifier -22, the note must quantify what pushed the case beyond the usual complexity. Incomplete operative reports are the leading cause of retrospective denial and recoupment for this code.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>CPT 21343 covers open treatment of a depressed frontal sinus fracture: descriptor, 090-day global period, modifiers, and when 21344 applies.<\/p>\n","protected":false},"author":83,"featured_media":179916,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"91","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[2614,2775,4199],"class_list":["post-179918","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-facial-trauma-documentation","tag-fracture-management","tag-plastic-surgery-billing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT Code 21343: Depressed Frontal Sinus Fracture<\/title>\n<meta name=\"description\" content=\"CPT Code 21343 for open treatment of depressed frontal sinus fracture, including procedure details, billing guidance &amp; coding considerations.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT Code 21343: Depressed Frontal Sinus Fracture\" \/>\n<meta property=\"og:description\" content=\"CPT Code 21343 for open treatment of depressed frontal sinus fracture, including procedure details, billing guidance &amp; coding considerations.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta 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is an all-in-one healthcare practice management software platform designed for clinics, medspas, therapists, and medical professionals. It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/#\\\/schema\\\/person\\\/f2e43b25ed02313e8781f0f4507398b9\",\"name\":\"Anja Dodevska\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"es\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-CE0C072E-91B7-4BB7-BD27-D1E3B38ED0CA-scaled-1-96x96.jpg\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-CE0C072E-91B7-4BB7-BD27-D1E3B38ED0CA-scaled-1-96x96.jpg\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-CE0C072E-91B7-4BB7-BD27-D1E3B38ED0CA-scaled-1-96x96.jpg\",\"caption\":\"Anja Dodevska\"},\"description\":\"Anja Dodevska writes about healthcare, dermatology, and the day-to-day realities of running a medical practice for Pabau. She enjoys breaking down complex topics into clear, accessible content and has a soft spot for the often-overlooked aspects of clinic life. When she's not writing, she's exploring cafes, walking her dog, or spending time with friends and family.\",\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/blog\\\/author\\\/anja-dodevska\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569193\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569193\",\"name\":\"What is CPT Code 21343 used for?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT Code 21343 bills open surgical treatment of a depressed frontal sinus fracture. The procedure covers surgical access to the fracture site, reduction of displaced bone fragments, and stabilization of the anterior table. It sits in the Musculoskeletal System's Fracture and\\\/or Dislocation Procedures on the Head subsection of the AMA CPT manual.\",\"inLanguage\":\"es\"},\"inLanguage\":\"es\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569194\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569194\",\"name\":\"What is the global period for CPT 21343?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The global period is 090 days, which classifies 21343 as major surgery under CMS guidelines. Every routine postoperative visit within 90 days of surgery is bundled into the surgical fee. Services outside the package can be billed separately with the right documentation and modifier. Those include a return to the operating room and an unrelated procedure.\",\"inLanguage\":\"es\"},\"inLanguage\":\"es\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569195\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569195\",\"name\":\"How does CPT 21343 differ from CPT 21344?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 21343 covers open treatment of a depressed frontal sinus fracture limited to the anterior table, with no complex intracranial involvement. CPT 21344 describes a more complex repair involving the posterior wall, severe comminution, or a coronal or multiple-approach access. The operative report decides it: posterior table repair or intracranial access moves the case from 21343 to 21344.\",\"inLanguage\":\"es\"},\"inLanguage\":\"es\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569196\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569196\",\"name\":\"Which ICD-10 codes support medical necessity for CPT 21343?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The codes paired most often are S02.19XA for a closed fracture of other specified skull and facial bones, and S02.19XB for the open fracture equivalent. S02.0XXA and S02.0XXB apply when frontal bone involvement extends to the skull vault. Every injury code needs the correct 7th character: A for the initial encounter, D for subsequent, and S for sequela. Check pairing acceptability against your MAC's local coverage determination.\",\"inLanguage\":\"es\"},\"inLanguage\":\"es\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569197\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/es\\\/procedure-codes\\\/cpt-code-21343\\\/#faq-question-1786626569197\",\"name\":\"What is the Medicare reimbursement rate for CPT 21343?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Medicare reimbursement is the total RVU multiplied by the annual CMS conversion factor, adjusted for the provider's Geographic Practice Cost Index locality. Geographic adjustment varies widely across the United States, so the allowed amount differs by location. 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It sits in the Musculoskeletal System's Fracture and\/or Dislocation Procedures on the Head subsection of the AMA CPT manual.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/#faq-question-1786626569194","position":2,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/#faq-question-1786626569194","name":"What is the global period for CPT 21343?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The global period is 090 days, which classifies 21343 as major surgery under CMS guidelines. Every routine postoperative visit within 90 days of surgery is bundled into the surgical fee. Services outside the package can be billed separately with the right documentation and modifier. Those include a return to the operating room and an unrelated procedure.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/#faq-question-1786626569195","position":3,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/#faq-question-1786626569195","name":"How does CPT 21343 differ from CPT 21344?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 21343 covers open treatment of a depressed frontal sinus fracture limited to the anterior table, with no complex intracranial involvement. CPT 21344 describes a more complex repair involving the posterior wall, severe comminution, or a coronal or multiple-approach access. The operative report decides it: posterior table repair or intracranial access moves the case from 21343 to 21344.","inLanguage":"es"},"inLanguage":"es"},{"@type":"Question","@id":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/#faq-question-1786626569196","position":4,"url":"https:\/\/pabau.com\/es\/procedure-codes\/cpt-code-21343\/#faq-question-1786626569196","name":"Which ICD-10 codes support medical necessity for CPT 21343?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The codes paired most often are S02.19XA for a closed fracture of other specified skull and facial bones, and S02.19XB for the open fracture equivalent. S02.0XXA and S02.0XXB apply when frontal bone involvement extends to the skull vault. Every injury code needs the correct 7th character: A for the initial encounter, D for subsequent, and S for sequela. 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