{"id":183264,"date":"2026-08-18T08:46:02","date_gmt":"2026-08-18T08:46:02","guid":{"rendered":"https:\/\/pabau.com\/?p=183264"},"modified":"2026-08-18T08:46:05","modified_gmt":"2026-08-18T08:46:05","slug":"cpt-code-21805","status":"publish","type":"post","link":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/","title":{"rendered":"CPT code 21805: Deleted status, successor codes, and billing guide"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT code 21805: Deleted status, successor codes, and billing guide\",\"description\":\"CPT code 21805 is deleted. Learn which successor code to bill, how to count ribs per side, and what the operative report must document.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21805\/\",\"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\":\"2026-08-07\",\"dateModified\":\"2026-08-18\"}<\/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 21805 is deleted and cannot be billed on a claim with a current date of service.<\/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>Three successor codes replaced it: CPT 21811 for 1 to 3 ribs, 21812 for 4 to 6, and 21813 for 7 or more.<\/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 successor descriptors are unilateral, so count the ribs fixed on each side separately.<\/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 report must state the number of ribs fixed, the surgical approach, and the hardware used.<\/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 keeps that operative detail attached to the claim, so denials do not come back for missing documentation.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT code 21805 is a deleted procedure code that covered open treatment of a rib fracture, with or without internal fixation. It is no longer valid on a claim, whatever the date of service. Open rib repair with internal fixation is now billed with CPT 21811, 21812, or 21813.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which one you use depends on how many ribs received fixation hardware on a single side. If 21805 shows up on an old chart or an <a href=\"https:\/\/pabau.com\/blog\/electronic-remittance-advice\/\">electronic remittance advice<\/a>, treat it as history. Submit it today and the claim comes back as invalid before a payer ever reviews it.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The American Medical Association updates the CPT code set every year. Codes get deleted when the clinical detail behind them needs a more granular descriptor, and that is what happened here. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This guide covers the successor codes, ICD-10 pairing, modifiers, reimbursement, and the documentation that keeps the claim paid.<\/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-21805-what-it-described-and-why-it-was-deleted\" class=\"wp-block-heading\">CPT code 21805: What it described and why it was deleted<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The descriptor read: <em>Open treatment of rib fracture, with or without internal fixation, each.<\/em> It covered surgical repair of a fractured rib through an open incision. Hardware such as plates, screws, or intramedullary devices was optional under that wording.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One descriptor could not separate a patient who needed one rib fixed from a patient who needed eight stabilized. Rib count drives operative time, resource use, and clinical risk. The successor codes carry that detail, which left 21805 with nothing of its own to describe.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Internal fixation is now built into the successor descriptors rather than left optional. An open repair performed without hardware does not map to any of the three replacement codes. Check the operative note for a named implant before you pick one.<\/p>\n\n\n\n<h2 id=\"h-replacement-codes-for-cpt-21805-21811-21812-and-21813\" class=\"wp-block-heading\">Replacement codes for CPT 21805: 21811, 21812, and 21813<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Three successor codes replaced 21805. Selection depends on the number of ribs treated with internal fixation on one side during a single operative session. The table below shows the crosswalk.<\/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\">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\">Full 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\">Ribs fixed<\/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\">Clinical context<\/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 21811<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 1-3 ribs<\/td>\n<td style=\"padding:12px 16px;color:#374151\">1 to 3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Isolated rib injuries and flail segments involving up to three ribs<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT 21812<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 4-6 ribs<\/td>\n<td style=\"padding:12px 16px;color:#374151\">4 to 6<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Moderate flail chest and multi-rib trauma from blunt force injury<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT 21813<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open treatment of rib fracture(s) with internal fixation, includes thoracoscopic visualization when performed, unilateral; 7 or more ribs<\/td>\n<td style=\"padding:12px 16px;color:#374151\">7 or more<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Extensive flail chest and high-energy trauma with massive rib involvement<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">All three descriptors include thoracoscopic visualization when performed, so it is not separately reportable alongside them. The <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC code lookup<\/a> confirms the current descriptors and any edits that apply to each code.<\/p>\n\n\n\n<h3 id=\"h-rib-count-how-to-select-the-right-code\" class=\"wp-block-heading\">Rib count: how to select the right code<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Count only the ribs that received internal fixation hardware during the session. Ribs that were fractured but managed without hardware do not count toward code selection. The operative report has to make that distinction in plain terms.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The descriptors are unilateral, so each side is counted on its own. Six ribs fixed on the right and two on the left gives 21812 for the right side and 21811 for the left. Summing both sides to reach 21813 overstates the procedure.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When the count sits on a boundary, such as exactly three ribs, record how you arrived at it. A note that shows the counting method holds up better under review than a bare total.<\/p>\n\n\n\n<h2 id=\"h-icd-10-cm-diagnosis-codes-that-support-the-claim\" class=\"wp-block-heading\">ICD-10-CM diagnosis codes that support the claim<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Every claim for 21811, 21812, or 21813 needs a supporting ICD-10-CM diagnosis code. Rib fracture codes sit in the S22 category. Laterality and displacement status have to match the operative report.<\/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\">Use when<\/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\">S22.31XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of one rib, right side, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Single right rib, first surgical encounter<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S22.32XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of one rib, left side, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Single left rib, first surgical encounter<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S22.41XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple fractures of ribs, right side, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple right ribs, first surgical encounter<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S22.42XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple fractures of ribs, left side, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple left ribs, first surgical encounter<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S22.43XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple fractures of ribs, bilateral, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bilateral multi-rib fractures, first surgical encounter<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S22.5XXA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Flail chest, initial encounter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Documented flail chest requiring surgical stabilization<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The seventh character A marks an initial encounter for active treatment. Subsequent encounters take D, delayed healing takes G, and sequelae take S. <a href=\"https:\/\/pabau.com\/diagnostic-codes\/icd-10-code-s42463g\/\">S42.463G<\/a> is a worked example of the delayed-healing character on another fracture site.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Use the <a href=\"https:\/\/crosscoder.com\/\" target=\"_blank\" rel=\"nofollow noopener\">CrossCoder crosswalk<\/a> to check code pairings and any medical necessity rules in your jurisdiction. Practices running <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> can attach the diagnosis at the point of care. That keeps the codes on the claim matched to the note.<\/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-21805\/automate-claims-through-healthcode.webp\" alt=\"Pabau claims and billing dashboard showing submitted claims\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&rsquo;s claims tools submit and track billing 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-applicable-modifiers-for-rib-fixation-codes\" class=\"wp-block-heading\">Applicable modifiers for rib fixation codes<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier choice for 21811 to 21813 follows the standard laterality and distinctness rules for musculoskeletal procedures. The table covers the ones you will meet most often.<\/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\">Meaning<\/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<\/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\">Caution<\/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\">-LT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left-sided rib fixation only<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required by most payers for a unilateral procedure<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Right-sided rib fixation only<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required by most payers for a unilateral procedure<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-50<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bilateral procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The same code applies to both sides in one session<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Some payers reject 50 and want separate LT and RT lines<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-59<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Distinct procedural service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A separate, distinctly documented procedure in the same session<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Check that no NCCI edit applies before appending it<\/td>\n<\/tr>\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 service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Substantially greater complexity documented in the operative report<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Needs detailed documentation and, for most payers, pre-approval<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Check the payer policy before you append modifier 50. Medicare generally accepts 50 on a single line for a bilateral procedure. Some commercial payers want two lines instead, one with LT and one with RT. Sending the wrong form is a common reason these claims sit in suspense rather than deny outright.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Laterality has to reach the operative note before anyone builds the claim. <a href=\"https:\/\/pabau.com\/features\/medical-records-management\/\">Medical records software<\/a> that holds the note and the codes together removes the retyping step where side and count get lost. The values then flow straight into the <a href=\"https:\/\/pabau.com\/blog\/837-file\/\">837 claim file<\/a>.<\/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-21805\/how-to-mark-injection-points-in-a-treatment-note.webp\" alt=\"Marking anatomical treatment sites on a body map inside a Pabau treatment note\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&rsquo;s treatment notes let you mark the exact anatomical sites treated, so laterality reaches the claim from the record itself.<\/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=\"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 your Medicare Administrative Contractor (MAC) coverage policy for rib fracture internal fixation before you submit. Some jurisdictions ask for prior authorization or a documentation checklist that differs from national CMS policy under article A53931. A denial at adjudication costs far more time than a review before submission.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-reimbursement-and-the-medicare-fee-schedule\" class=\"wp-block-heading\">Reimbursement and the Medicare fee schedule<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare payment for rib fixation codes is set each year through the Medicare Physician Fee Schedule (MPFS). Rates vary by geographic locality and by facility status. For current payment amounts and RVU values, use the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS fee schedule lookup<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">As a benchmark, 21813 carries the highest work RVU of the three codes and 21811 the lowest, which tracks operative time and complexity. Commercial rates are negotiated individually and vary widely. Reconcile against the current MPFS rather than a cached rate table, because third-party rate data goes stale quietly.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau&rsquo;s <a href=\"https:\/\/pabau.com\/features\/reports-software\/\">reporting tools<\/a> show what each code was paid, payer by payer. An underpayment on 21812 then surfaces in a report rather than at year end. Reporting comes with every Pabau subscription, so a single-site trauma practice sees the same figures as a large group.<\/p>\n\n\n\n<h2 id=\"h-medicare-and-payer-coverage-guidelines\" class=\"wp-block-heading\">Medicare and payer coverage guidelines<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CMS documents coverage for rib fracture internal fixation in article A53931. The article states that 21805 is no longer valid and lists 21811, 21812, and 21813 as the covered codes. Medical necessity has to be established and documented before surgery.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Coverage generally requires one or more of these clinical indicators in the medical record:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Flail chest with respiratory compromise<\/li>\n\n\n\n<li>Chest wall deformity with pain that impairs ventilation<\/li>\n\n\n\n<li>Non-union or malunion of a previously treated rib fracture<\/li>\n\n\n\n<li>Failure of conservative management over an appropriate observation period<\/li>\n\n\n\n<li>Ventilator dependence attributable to rib instability<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Local Coverage Determinations from Medicare Administrative Contractors can add requirements on top of national policy. Billing teams at <a href=\"https:\/\/pabau.com\/industry\/sports-medicine-software\/\">sports medicine practices<\/a> should confirm which MAC covers their region before assuming national policy applies unchanged.<\/p>\n\n\n\n<h2 id=\"h-documentation-requirements-for-internal-rib-fixation-claims\" class=\"wp-block-heading\">Documentation requirements for internal rib fixation claims<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Denials for 21811 to 21813 nearly always trace back to the same thing. The operative report never states how many ribs received internal fixation, at least not in words that map to a code. The surgeon describes the procedure clinically and the count stays implied.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These elements belong in the operative report and the supporting record:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Exact rib count:<\/strong> the number of ribs fixed, not the number fractured<\/li>\n\n\n\n<li><strong>Laterality:<\/strong> right, left, or bilateral, with a count for each side<\/li>\n\n\n\n<li><strong>Operative approach:<\/strong> open incision confirmed, plus thoracoscopic visualization if used<\/li>\n\n\n\n<li><strong>Fixation hardware:<\/strong> the implant system by name, such as plates, screws, or intramedullary struts<\/li>\n\n\n\n<li><strong>Pre-operative imaging:<\/strong> CT or X-ray confirming the fracture pattern and the ribs involved<\/li>\n\n\n\n<li><strong>Medical necessity:<\/strong> the clinical reasoning for operative rather than conservative management<\/li>\n\n\n\n<li><strong>Surgeon attestation:<\/strong> the operating surgeon signs and dates the report<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Rehabilitation teams at <a href=\"https:\/\/pabau.com\/industry\/physical-therapy-emr\/\">physical therapy practices<\/a> need the same operative detail for their follow-up coding. Linking the surgical record to outpatient visits cuts duplicate documentation and keeps coding consistent across the whole episode of care.<\/p>\n\n\n\n<h2 id=\"h-common-billing-errors-with-the-successor-codes\" class=\"wp-block-heading\">Common billing errors with the successor codes<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Each mistake below has a direct fix, and most get caught before the claim leaves the practice. The first one stops at the <a href=\"https:\/\/pabau.com\/blog\/medical-claims-clearinghouse\/\">medical claims clearinghouse<\/a>, which will not forward a deleted code to a payer.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Submitting 21805:<\/strong> a claim carrying the deleted code is rejected before adjudication. Remove it from the charge description master if it is still selectable.<\/li>\n\n\n\n<li><strong>Miscounting ribs:<\/strong> the code follows ribs fixed, not ribs fractured. Six fractures with three ribs plated supports 21811, not 21812.<\/li>\n\n\n\n<li><strong>Missing laterality:<\/strong> a rib fixation code without LT or RT is suspended by many payers. Append the modifier unless you are billing 50 for documented bilateral work.<\/li>\n\n\n\n<li><strong>Unbundling thoracoscopy:<\/strong> thoracoscopic visualization is included in the descriptor. Billing it separately triggers an NCCI edit.<\/li>\n\n\n\n<li><strong>Thin medical necessity:<\/strong> a fracture diagnosis alone will not carry the claim. The record has to say why conservative management was insufficient.<\/li>\n\n\n\n<li><strong>Wrong seventh character:<\/strong> an initial surgical encounter takes A. Using D or dropping the character rejects the diagnosis and the whole claim with it.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">A pre-submission review of those six points is faster than reworking denials later. Reading the <a href=\"https:\/\/pabau.com\/blog\/denial-codes-in-medical-billing\/\">denial codes<\/a> on the remittance tells you which of them your team repeats most.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A <a href=\"https:\/\/pabau.com\/blog\/clean-claim\/\">clean claim<\/a> on the first pass also shortens the payment cycle on high-value trauma work. A <a href=\"https:\/\/pabau.com\/blog\/hipaa-compliance-for-medical-offices\/\">HIPAA-compliant documentation process<\/a> protects the practice if an audit reaches back to these claims.<\/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>Audit your 21811 to 21813 claims once a quarter. Pull the denial reason codes and sort them into three buckets: laterality modifiers, rib count mismatches, and missing medical necessity. Each bucket needs a different process fix, and treating the cause beats correcting claims one at a time.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-how-pabau-ties-operative-detail-to-the-right-rib-fixation-code\" class=\"wp-block-heading\">How Pabau ties operative detail to the right rib fixation code<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most trauma billing teams work backward. The coder opens the operative report days after surgery, hunts for a rib count, and emails the surgeon when it is not there. Meanwhile the <a href=\"https:\/\/pabau.com\/blog\/timely-filing-limits\/\">timely filing<\/a> clock keeps running.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau keeps the clinical note and the claim in one patient record. The surgeon records rib count, side, and hardware in a structured treatment note at the point of care. The coder reads those fields while building the claim, so nobody chases a missing number by email.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Because reporting sits in the same system, you can see which codes were paid, which were denied, and why. That turns a quarterly denial audit into a report you can run in a minute. Practices spend the time saved on appeals that are worth filing.<\/p>\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                    Capture rib count and laterality at the point of care                <\/h3>\n\n                <p class=\"description\">\n                    Pabau keeps operative detail, diagnosis codes, and claims in one patient record, so surgical and trauma billing teams stop chasing documentation after the fact.                <\/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\"\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\">The deletion of 21805 is settled, so the work now sits in the documentation. Count ribs per side, name the hardware, and say why conservative care was not enough. Do that and the code selects itself.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Build those three items into the operative note template and coding stops being a negotiation. Retrofit them weeks later and you are arguing with a payer about a record that has already been signed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The trade-off is worth remembering. A few extra lines in the operative report buy a claim that survives review. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau keeps rib fixation documentation and claims in the same record.<\/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>Managing CPT deletions across your charge master?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/coaching-cpt-codes\/\">Coaching CPT codes<\/a> shows how the annual AMA update ripples through a specialty code set.<\/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>Sequencing several procedure codes on one claim?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/ivf-cpt-codes\/\">IVF CPT codes<\/a> works through multi-code billing for a single episode of care.<\/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 chest trauma alongside rib repair?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20102\/\">CPT code 20102<\/a> covers wound exploration billing and the documentation it 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>Denials piling up on high-value surgical claims?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/denial-management-in-healthcare\/\">Denial management in healthcare<\/a> sets out a process for finding and fixing root causes.<\/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>Worried about a retrospective audit?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/medical-billing-compliance\/\">Medical billing compliance<\/a> explains the controls that keep clinical documentation audit-ready.<\/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-1786974828966\"><h3 class=\"schema-faq-question\">What is CPT code 21805?<\/h3> <p class=\"schema-faq-answer\">CPT code 21805 is a deleted procedure code. It covered open treatment of a rib fracture, with or without internal fixation. The American Medical Association replaced it with three rib-count-specific codes: CPT 21811, CPT 21812, and CPT 21813.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974828967\"><h3 class=\"schema-faq-question\">What replaced CPT code 21805?<\/h3> <p class=\"schema-faq-answer\">Three codes replaced it. CPT 21811 covers 1 to 3 ribs, CPT 21812 covers 4 to 6 ribs, and CPT 21813 covers 7 or more. The descriptors are unilateral, so count the ribs fixed on each side separately.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974828968\"><h3 class=\"schema-faq-question\">Why was CPT code 21805 deleted?<\/h3> <p class=\"schema-faq-answer\">One descriptor could not reflect the difference between fixing one rib and fixing seven. Rib-count-specific codes let payers reimburse for the resource intensity of each case. Internal fixation is also required under the successor codes, rather than optional.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974828969\"><h3 class=\"schema-faq-question\">Does Medicare cover rib fracture internal fixation?<\/h3> <p class=\"schema-faq-answer\">Yes. Medicare covers it under CMS article A53931, which lists 21811, 21812, and 21813 as covered codes. Coverage requires documented medical necessity, such as flail chest, respiratory compromise, or failed conservative management. Your MAC may add local requirements.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974828970\"><h3 class=\"schema-faq-question\">How do I bill open rib fracture treatment now?<\/h3> <p class=\"schema-faq-answer\">Bill 21811, 21812, or 21813 based on the rib count in the operative report. Append LT, RT, or 50 for a documented bilateral repair. Pair the code with an S22 diagnosis carrying the correct seventh character. Check your MAC policy before submitting.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786974828971\"><h3 class=\"schema-faq-question\">Which ICD-10 codes pair with CPT 21811 to 21813?<\/h3> <p class=\"schema-faq-answer\">The S22 category carries them. Use S22.31XA or S22.32XA for a single rib fracture, right or left. Multiple fractures on one side take S22.41XA or S22.42XA, and bilateral fractures take S22.43XA. Flail chest is S22.5XXA.<\/p> <\/div> <\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>CPT code 21805 is a deleted procedure code that covered open treatment of a rib fracture, with or without internal fixation. It is no longer valid on a claim, whatever the date of service. Open rib repair with internal fixation is now billed with CPT 21811, 21812, or 21813. Which one you use depends on [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":183261,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"84","_yoast_wpseo_content_score":"90","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546,1125,1127],"tags":[1543,1162,1602,2775,1666],"class_list":["post-183264","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","category-musculoskeletal-pain-management","category-sports-medicine","tag-clinical-documentation","tag-cpt-codes","tag-cpt-modifiers","tag-fracture-management","tag-orthopedic-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 21805 is deleted: Bill 21811, 21812, or 21813<\/title>\n<meta name=\"description\" content=\"CPT 21805 is deleted. Bill 21811, 21812, or 21813 by the ribs fixed on each side, because the descriptors are unilateral.\" \/>\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\/fr\/procedure-codes\/cpt-code-21805\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT code 21805 is deleted: Bill 21811, 21812, or 21813\" \/>\n<meta property=\"og:description\" content=\"CPT 21805 is deleted. Bill 21811, 21812, or 21813 by the ribs fixed on each side, because the descriptors are unilateral.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-18T08:46:02+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-18T08:46:05+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-21805.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Anja Dodevska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"\u00c9crit par\" \/>\n\t<meta name=\"twitter:data1\" content=\"Anja Dodevska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Dur\u00e9e de lecture estim\u00e9e\" \/>\n\t<meta name=\"twitter:data2\" content=\"11 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/\"},\"author\":{\"name\":\"Anja Dodevska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#\\\/schema\\\/person\\\/f2e43b25ed02313e8781f0f4507398b9\"},\"headline\":\"CPT code 21805: Deleted status, successor codes, and billing guide\",\"datePublished\":\"2026-08-18T08:46:02+00:00\",\"dateModified\":\"2026-08-18T08:46:05+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/\"},\"wordCount\":2236,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-21805.webp\",\"keywords\":[\"Clinical Documentation\",\"CPT Codes\",\"Cpt Modifiers\",\"Fracture management\",\"Orthopedic Billing\"],\"articleSection\":[\"Billing Codes\",\"CPT Codes\",\"Musculoskeletal &amp; Pain Management\",\"Sports Medicine\"],\"inLanguage\":\"fr-FR\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/\",\"name\":\"CPT code 21805 is deleted: Bill 21811, 21812, or 21813\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-21805.webp\",\"datePublished\":\"2026-08-18T08:46:02+00:00\",\"dateModified\":\"2026-08-18T08:46:05+00:00\",\"description\":\"CPT 21805 is deleted. 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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\\\/fr\\\/#\\\/schema\\\/person\\\/f2e43b25ed02313e8781f0f4507398b9\",\"name\":\"Anja Dodevska\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"fr-FR\",\"@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\\\/fr\\\/blog\\\/author\\\/anja-dodevska\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828966\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828966\",\"name\":\"What is CPT code 21805?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT code 21805 is a deleted procedure code. It covered open treatment of a rib fracture, with or without internal fixation. The American Medical Association replaced it with three rib-count-specific codes: CPT 21811, CPT 21812, and CPT 21813.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828967\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828967\",\"name\":\"What replaced CPT code 21805?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Three codes replaced it. CPT 21811 covers 1 to 3 ribs, CPT 21812 covers 4 to 6 ribs, and CPT 21813 covers 7 or more. The descriptors are unilateral, so count the ribs fixed on each side separately.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828968\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828968\",\"name\":\"Why was CPT code 21805 deleted?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"One descriptor could not reflect the difference between fixing one rib and fixing seven. Rib-count-specific codes let payers reimburse for the resource intensity of each case. Internal fixation is also required under the successor codes, rather than optional.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828969\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828969\",\"name\":\"Does Medicare cover rib fracture internal fixation?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. Medicare covers it under CMS article A53931, which lists 21811, 21812, and 21813 as covered codes. Coverage requires documented medical necessity, such as flail chest, respiratory compromise, or failed conservative management. Your MAC may add local requirements.\",\"inLanguage\":\"fr-FR\"},\"inLanguage\":\"fr-FR\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828970\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/fr\\\/procedure-codes\\\/cpt-code-21805\\\/#faq-question-1786974828970\",\"name\":\"How do I bill open rib fracture treatment now?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Bill 21811, 21812, or 21813 based on the rib count in the operative report. Append LT, RT, or 50 for a documented bilateral repair. Pair the code with an S22 diagnosis carrying the correct seventh character. 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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\/fr\/blog\/author\/anja-dodevska\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828966","position":1,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828966","name":"What is CPT code 21805?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT code 21805 is a deleted procedure code. It covered open treatment of a rib fracture, with or without internal fixation. The American Medical Association replaced it with three rib-count-specific codes: CPT 21811, CPT 21812, and CPT 21813.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828967","position":2,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828967","name":"What replaced CPT code 21805?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Three codes replaced it. CPT 21811 covers 1 to 3 ribs, CPT 21812 covers 4 to 6 ribs, and CPT 21813 covers 7 or more. The descriptors are unilateral, so count the ribs fixed on each side separately.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828968","position":3,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828968","name":"Why was CPT code 21805 deleted?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"One descriptor could not reflect the difference between fixing one rib and fixing seven. Rib-count-specific codes let payers reimburse for the resource intensity of each case. Internal fixation is also required under the successor codes, rather than optional.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828969","position":4,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828969","name":"Does Medicare cover rib fracture internal fixation?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes. Medicare covers it under CMS article A53931, which lists 21811, 21812, and 21813 as covered codes. Coverage requires documented medical necessity, such as flail chest, respiratory compromise, or failed conservative management. Your MAC may add local requirements.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828970","position":5,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828970","name":"How do I bill open rib fracture treatment now?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Bill 21811, 21812, or 21813 based on the rib count in the operative report. Append LT, RT, or 50 for a documented bilateral repair. Pair the code with an S22 diagnosis carrying the correct seventh character. Check your MAC policy before submitting.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"},{"@type":"Question","@id":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828971","position":6,"url":"https:\/\/pabau.com\/fr\/procedure-codes\/cpt-code-21805\/#faq-question-1786974828971","name":"Which ICD-10 codes pair with CPT 21811 to 21813?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The S22 category carries them. Use S22.31XA or S22.32XA for a single rib fracture, right or left. Multiple fractures on one side take S22.41XA or S22.42XA, and bilateral fractures take S22.43XA. Flail chest is S22.5XXA.","inLanguage":"fr-FR"},"inLanguage":"fr-FR"}]}},"yoast":{"focus_keyword":"cpt code 21805","seo_title":"CPT code 21805 is deleted: Bill 21811, 21812, or 21813","meta_description":"CPT 21805 is deleted. 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