{"id":175975,"date":"2026-08-12T08:14:22","date_gmt":"2026-08-12T08:14:22","guid":{"rendered":"https:\/\/pabau.com\/?p=175975"},"modified":"2026-08-12T08:14:24","modified_gmt":"2026-08-12T08:14:24","slug":"cpt-code-21122","status":"publish","type":"post","link":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21122\/","title":{"rendered":"CPT code 21122: Genioplasty sliding osteotomy billing guide"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 21122: Genioplasty Sliding Osteotomy with Two or More Osteotomies\",\"description\":\"CPT Code 21122 covers genioplasty with sliding osteotomy involving two or more osteotomies. Learn billing rules, modifiers, Medicare rates, ICD-10 crosswalk, and documentation requirements.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21122\/\",\"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\":\"2026-08-12\"}<\/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 21122 covers a genioplasty performed with two or more sliding osteotomies of the chin.<\/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 osteotomy count is what separates 21122 from 21121, so the operative note must describe every cut.<\/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>Medicare rates reset each January, so check the current facility and non-facility figures before you bill.<\/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>US claims pair the code with an M26 diagnosis, because ICD-10-CM has no K07 category at all.<\/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 modifiers, diagnoses, and authorization status to the patient record.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\"><strong>CPT code 21122<\/strong> is the billable code for a genioplasty performed with two or more sliding osteotomies of the chin. Payers read the osteotomy count in the operative note to decide whether a claim belongs here or under 21121. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This guide covers the descriptor, modifier rules, 2026 fee schedule mechanics, the ICD-10-CM crosswalk, and the documentation that supports a clean claim.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Billing teams at oral and maxillofacial surgery practices and <a href=\"https:\/\/pabau.com\/blog\/opening-a-cosmetic-surgery-clinic\/\">cosmetic surgery practices<\/a> meet this code when chin repositioning needs correction in more than one plane. Knowing where 21122 starts and 21121 ends prevents undercoding and overcoding alike.<\/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-21122-definition-and-clinical-description\" class=\"wp-block-heading\">CPT code 21122: Definition and clinical description<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The official AMA CPT descriptor reads: <em>Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)<\/em>. The code sits in the Repair, Revision, and\/or Reconstruction Procedures on the Head section of the CPT manual. Its genioplasty range runs from 21120 to 21123.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Surgeons use it when the chin is repositioned through two or more separate cuts in the mandibular symphysis. The freed segment is then advanced, retracted, or rotated. Multiple cuts allow three-dimensional movement that a single straight osteotomy cannot achieve, such as vertical shortening combined with horizontal advancement.<\/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\">Detail<\/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\">21122<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT section<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Repair, Revision, and\/or Reconstruction Procedures on the Head<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Specialty<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Oral and maxillofacial surgery, plastic surgery, craniofacial surgery<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billable status<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes, standalone billable, and it may be co-reported with orthognathic codes<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 id=\"h-what-the-sliding-osteotomy-procedure-involves\" class=\"wp-block-heading\">What the sliding osteotomy procedure involves<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A sliding genioplasty separates a segment of the chin bone and moves it to a new position before plating it in place. The code applies when the surgeon makes two or more separate cuts to achieve that movement. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A single horizontal cut is coded 21121, because one cut only translates the segment in one plane. Two or more cuts let the surgeon reshape the segment itself.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Three scenarios usually call for more than one cut:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Asymmetry correction that needs a wedge removed<\/li>\n\n\n\n<li>Vertical height reduction combined with horizontal advancement<\/li>\n\n\n\n<li>Rotation of the chin segment to correct a midline deviation<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Step 1: Incision.<\/strong> A mucosal incision is made intraorally at the vestibule, below the lower lip, exposing the anterior mandible.<\/li>\n\n\n\n<li><strong>Step 2: Periosteal elevation.<\/strong> The soft tissue is elevated from the bone to visualize the inferior border and mental nerve foramina bilaterally.<\/li>\n\n\n\n<li><strong>Step 3: First osteotomy.<\/strong> A horizontal cut is made below the mental foramina with a reciprocating or oscillating saw.<\/li>\n\n\n\n<li><strong>Step 4: Additional osteotomy or osteotomies.<\/strong> One or more further cuts allow wedge removal, vertical shortening, or segmental reshaping. This is the clinical distinction that justifies 21122 over 21121.<\/li>\n\n\n\n<li><strong>Step 5: Repositioning and fixation.<\/strong> The freed segment is moved to the planned position and secured with titanium plates and screws.<\/li>\n\n\n\n<li><strong>Step 6: Wound closure.<\/strong> The periosteum and mucosa are closed in layers.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The operative report has to identify each osteotomy and its purpose. Without that detail, payers downcode to 21121 or deny the claim outright.<\/p>\n\n\n\n<h2 id=\"h-how-21122-compares-with-21120-21121-and-21123\" class=\"wp-block-heading\">How 21122 compares with 21120, 21121, and 21123<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Four codes cover genioplasty in the CPT manual. Picking the wrong one is the most common error on these claims, and 21121 and 21122 are the pair coders confuse most. The same descriptor-first logic applies across other specialty families, including the <a href=\"https:\/\/pabau.com\/procedure-codes\/ivf-cpt-codes\/\">IVF CPT codes<\/a>. The table below sets all four genioplasty codes side by side.<\/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\">Official 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\">Technique<\/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 differentiator<\/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\">21120<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Genioplasty; augmentation (autograft, allograft, or prosthetic material)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Implant or graft placement, no osteotomy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">No bone cut, chin volume added by material<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21121<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Genioplasty; sliding osteotomy, single piece<\/td>\n<td style=\"padding:12px 16px;color:#374151\">One horizontal cut, segment moved as one piece<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A single osteotomy, movement in one plane<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21122<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Two or more bone cuts, multi-plane movement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple cuts, three-dimensional repositioning or reshaping<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21123<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Sliding osteotomy plus interpositional bone grafts<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Graft harvest is bundled, never billed separately<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 21120 involves no osteotomy at all, so augmentation versus sliding is the first decision point. Between 21121 and 21122, the osteotomy count in the operative note settles it. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 21123 adds interpositional bone grafts to a sliding genioplasty, and the descriptor already includes obtaining the autograft. That means the harvest is bundled into 21123 rather than billed as a separate service.<\/p>\n\n\n\n<h2 id=\"h-applicable-modifiers-for-cpt-code-21122\" class=\"wp-block-heading\">Applicable modifiers for CPT code 21122<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection follows standard NCCI bundling rules, which CMS updates quarterly. Check modifier applicability against the current <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule<\/a> edits before you bill. The table below covers the modifiers that come up most often on genioplasty claims.<\/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 apply<\/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\">-51<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21122 billed alongside other surgical procedures in the same session, such as LeFort I or BSSO. Apply it to the secondary procedures, not the primary one. Check NCCI edits first.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\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\">Unusual complexity beyond the descriptor, such as severe scarring from prior surgery or abnormal anatomy. The operative note has to support it.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\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\">Marks 21122 as a separate service that NCCI edits would otherwise bundle. Use the X modifiers instead where the payer accepts them.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-53<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Discontinued procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The procedure started but was stopped for patient safety. Rare in elective genioplasty, but it applies if anesthesia complications arise.<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-78<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unplanned return to OR<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A return to the operating room for a complication during the postoperative period, such as hardware failure or hematoma.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier -51 is not universal. Medicare and many commercial payers recognize it, while others want -59 or the X modifier subset instead. Confirm each payer&#8217;s rule before submission.<\/p>\n\n\n\n<h2 id=\"h-fee-schedule-and-reimbursement-in-year\" class=\"wp-block-heading\">Fee schedule and reimbursement in 2026<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Genioplasty reimbursement under Medicare is a surgical global package. It covers the preoperative visits, the procedure itself, and standard postoperative care. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Payment depends on geographic adjustment, place of service, and the annual conversion factor. Verify the current figures in the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\" target=\"_blank\" rel=\"nofollow noopener\">CMS MPFS look-up tool<\/a> for the applicable payment year.<\/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\">Rate type<\/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\">Note<\/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\">Non-facility (office or ASC)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician work RVU plus the non-facility practice expense RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Generally higher than the facility rate, because practice expense RVUs are not reduced<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Facility (hospital outpatient)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physician work RVU with a reduced practice expense RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The hospital is paid separately through OPPS, so the surgeon bills only the physician component<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Geographic adjustment<\/td>\n<td style=\"padding:12px 16px;color:#374151\">GPCI multipliers applied to the work, practice expense, and malpractice RVUs<\/td>\n<td style=\"padding:12px 16px;color:#374151\">High-cost localities pay materially more than rural ones<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Private payer range<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Set by contract, commonly a percentage of the Medicare allowable<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Facial reconstruction codes tend to carry favorable surgical RVUs<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Three RVU components drive the payment: physician work, practice expense, and malpractice. Each one is adjusted by your locality&#8217;s GPCI values, then multiplied by the year&#8217;s conversion factor. Run the numbers for your own contractor region rather than working from a national average.<\/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>Compare the facility and non-facility rates for CPT 21122 in your area before you advise on surgical venue. If your contract pays a percentage of Medicare, the ASC and hospital figures can differ enough to matter. Check again every January, when MPFS rates reset.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-icd-10-cm-codes-used-with-cpt-21122\" class=\"wp-block-heading\">ICD-10-CM codes used with CPT 21122<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Payers want a linked ICD-10-CM diagnosis that establishes medical necessity. The diagnosis has to reflect what the record documents. Never pick a code just to satisfy coverage criteria when it does not match the patient&#8217;s condition. The table below lists the codes that fit genioplasty indications, grouped by clinical picture.<\/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\">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\">M26.00<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified anomaly of jaw size<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The record documents a jaw size anomaly without naming macrogenia or microgenia<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M26.05<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Macrogenia<\/td>\n<td style=\"padding:12px 16px;color:#374151\">An oversized chin corrected by reduction or setback<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M26.06<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Microgenia<\/td>\n<td style=\"padding:12px 16px;color:#374151\">An underdeveloped chin, the usual indication for advancement<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M26.10<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unspecified anomaly of jaw-cranial base relationship<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Skeletal class II or III with a chin component, base relationship not specified<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M26.4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malocclusion, unspecified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Genioplasty forms part of a broader orthognathic correction<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G47.33<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Obstructive sleep apnea (adult, pediatric)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Genioplasty performed as part of sleep apnea surgical management<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q67.4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other congenital deformities of skull, face and jaw<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Congenital chin deformity needing surgical correction<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S02.600A\/D\/S<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of mandible, unspecified, by episode of care<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Post-traumatic chin deformity corrected by genioplasty<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">One trap catches US coders repeatedly. Plenty of genioplasty crosswalks list K07.0, K07.1, and K07.29 for jaw anomalies, and those are WHO ICD-10 codes rather than ICD-10-CM ones. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The US clinical modification has no K07 category at all, because K06 is followed by K08. A K07 code on a US claim rejects before a payer ever reviews it, so jaw anomalies belong in the M26 category.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">You can check the crosswalk against the <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC code lookup<\/a>, which lists associated diagnoses and coverage policies. Confirm that the diagnosis code is valid for the date of service. ICD-10-CM updates take effect every October 1.<\/p>\n\n\n\n<h2 id=\"h-documentation-requirements-for-cpt-code-21122\" class=\"wp-block-heading\">Documentation requirements for CPT code 21122<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The operative report is the first document a payer examines on audit. Since the code turns on the number of osteotomies, the report has to make each cut unambiguous. Practices working from <a href=\"https:\/\/pabau.com\/blog\/medical-forms-at-your-healthcare-practice\/\">structured clinical documentation<\/a> spend less time chasing surgeons for missing operative detail.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Osteotomy count documented explicitly.<\/strong> The note names each osteotomy and describes its location, direction, and purpose. &#8220;Multiple cuts were made&#8221; is not enough. Each cut needs its own description. Name the horizontal osteotomy below the mental foramina, then the second oblique cut that removes a 4mm wedge.<\/li>\n\n\n\n<li><strong>Medical necessity narrative.<\/strong> The preoperative record explains why one cut could not achieve the planned correction. That narrative links the diagnosis to the surgical approach.<\/li>\n\n\n\n<li><strong>Imaging on file.<\/strong> Preoperative cephalometric radiographs and planning records support necessity for complex skeletal corrections. Payers often ask for them on appeal.<\/li>\n\n\n\n<li><strong>Anesthesia type and duration.<\/strong> Genioplasty is performed under general anesthesia. Document the start and stop times, and leave the anesthesia codes to the anesthesiologist.<\/li>\n\n\n\n<li><strong>Postoperative diagnosis consistent with the findings.<\/strong> The diagnosis on the claim should match the operative note. Discrepancies between the two are a common audit trigger.<\/li>\n<\/ul>\n\n\n\n<h3 id=\"h-prior-authorization-and-insurance-coverage\" class=\"wp-block-heading\">Prior authorization and insurance coverage<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Coverage varies by payer and by clinical indication. Cosmetic genioplasty is almost universally excluded. Functional indications such as skeletal malocclusion, sleep apnea surgery, and post-traumatic deformity may qualify, and each payer applies its own criteria. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The same cosmetic-versus-functional test governs other facial procedures, including <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-15822\/\">CPT 15822<\/a>.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Submit the request before scheduling.<\/strong> Most commercial payers and Medicare Advantage plans require prior authorization for facial bone reconstruction. Submitting without it leads to a non-covered denial that cannot be appealed on medical necessity grounds.<\/li>\n\n\n\n<li><strong>Include the supporting clinical record.<\/strong> Attach the cephalometric analysis, sleep study results, orthodontic records, and the surgeon&#8217;s letter of medical necessity. A reusable <a href=\"https:\/\/pabau.com\/templates\/medical-prior-authorization-form\/\">prior authorization form<\/a> keeps every submission consistent.<\/li>\n\n\n\n<li><strong>Document the functional impairment.<\/strong> Payers approve correction when the deformity causes a measurable deficit. A cephalometric measurement alone persuades less than a documented problem, such as an occlusion that orthodontics could not settle.<\/li>\n\n\n\n<li><strong>Anticipate the common denials.<\/strong> Thin evidence of functional impairment and a diagnosis that reads as cosmetic are the usual two. A procedure outside the coverage policy and an unauthorized out-of-network surgeon follow close behind.<\/li>\n<\/ul>\n\n\n\n<h2 id=\"h-co-reporting-21122-in-orthognathic-and-sleep-apnea-cases\" class=\"wp-block-heading\">Co-reporting 21122 in orthognathic and sleep apnea cases<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Genioplasty is rarely performed on its own at major orthognathic centers. Surgeons correcting skeletal malocclusion with a LeFort I osteotomy or a bilateral sagittal split work in the same field. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">They often add a genioplasty in the session to settle chin position. CPT 21122 can be co-reported with those codes, subject to NCCI multiple-procedure rules and each payer&#8217;s bundling policy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Other mandibular work follows the same documentation logic on a combined claim. Interdental fixation under <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21110\/\">CPT 21110<\/a> and open fracture treatment under <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21470\/\">CPT 21470<\/a> both need their own operative detail. Trauma cases can also pair the genioplasty with alveolar ridge repair.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Genioplasty codes also appear in sleep apnea surgical planning, where chin advancement improves tongue base position and airway patency. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When G47.33 is the primary diagnosis, the authorization packet should carry the polysomnography results, evidence of CPAP failure, and an airway assessment. Consistent templates keep that packet the same for every case.<\/p>\n\n\n\n<h2 id=\"h-how-practice-management-software-supports-cpt-21122-billing\" class=\"wp-block-heading\">How practice management software supports CPT 21122 billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Specialty surgical codes create three recurring billing problems: modifier errors, mismatched diagnosis links, and authorizations that nobody tracked. Each one delays payment, and together they hold a meaningful share of accounts receivable in oral and maxillofacial surgery practices.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau handles these at the workflow level instead of during claims correction. For <a href=\"https:\/\/pabau.com\/industry\/plastic-surgery-emr\/\">plastic surgery practices<\/a> and <a href=\"https:\/\/pabau.com\/industry\/dermatology-emr-software\/\">dermatology practices<\/a> alike, billing stays connected to the clinical record from the point of scheduling. Nothing has to be reassembled from separate systems after the case is done.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Modifier prompting.<\/strong> When a coder enters 21122, the system flags the applicable modifiers and asks for confirmation before submission. That catches the multi-procedure claim that would otherwise go out bare. Pabau&#8217;s <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> supports modifier-level review at that point.<\/li>\n\n\n\n<li><strong>Diagnosis linkage.<\/strong> Linking the M26 or G47.33 diagnosis at the encounter, rather than at submission, keeps the claim consistent with the note. <a href=\"https:\/\/pabau.com\/features\/medical-records-management\/\">Digital patient records<\/a> carry the diagnosis through to the claim, so nobody re-keys it.<\/li>\n\n\n\n<li><strong>Authorization tracking.<\/strong> Authorization status, reference numbers, and approval dates sit in the patient record, so no claim goes out ahead of its approval. <a href=\"https:\/\/pabau.com\/features\/automated-workflows-software\/\">Automated billing workflows<\/a> flag the cases that need authorization before they reach the scheduler.<\/li>\n\n\n\n<li><strong>Operative note templates.<\/strong> <a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">Digital clinical forms<\/a> built for oral surgery capture osteotomy count, location, and purpose in a structured field set. A good template also gets the surgeon out of charting faster.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Practices weighing up systems can compare the options in this guide to <a href=\"https:\/\/pabau.com\/blog\/best-plastic-surgery-software\/\">plastic surgery software<\/a>. A closer look at a purpose-built <a href=\"https:\/\/pabau.com\/blog\/plastic-surgery-practice-emr-software\/\">plastic surgery EMR<\/a> covers what it adds to surgical documentation and billing.<\/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>Build a charge capture checklist for 21122. Confirm the osteotomy count in the operative note and the M26 diagnosis. Then check the authorization number and the modifier list for co-billed orthognathic codes. Anesthesia is coded separately. Running that check before submission keeps denials off complex surgical claims.<\/p>\n            <\/div>\n        <\/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                    Manage complex surgical billing with fewer errors                <\/h3>\n\n                <p class=\"description\">\n                    Pabau links modifiers, diagnoses, and authorization status to the patient record. Your team can check a CPT 21122 claim before it ever leaves the practice.                <\/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 software for surgical specialties\"\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\">Genioplasty claims turn on a few lines of the operative note. Name each cut and its purpose, and 21122 holds up under audit. Say only that multiple cuts were made, and the payer reads the case as 21121 and pays accordingly.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Put the check in the workflow instead of the appeal. Confirm the osteotomy count, the M26 diagnosis, and the authorization number before the claim leaves the practice. That is the difference between payment in three weeks and an argument that runs for three months.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau keeps that check in one place, so modifier selection, diagnosis linkage, and authorization tracking happen before submission rather than after a denial. To see how it works for oral and maxillofacial or plastic surgery billing, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a>.<\/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>Coding another maxillofacial fracture repair?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21407\/\">CPT code 21407<\/a> walks through open treatment of an orbital fracture with an implant, including the documentation payers ask for.<\/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>Billing an excision on the maxilla?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21049\/\">CPT code 21049<\/a> covers benign tumor and cyst excision, with the modifier rules that apply on combined oral surgery claims.<\/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>Need the facial plastic side of the same code family?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-15828\/\">CPT code 15828<\/a> explains rhytidectomy of the cheek, chin, and neck, and where coverage usually lands.<\/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>Unsure which NPI belongs on the claim?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/type-1-vs-type-2-npi\/\">Type 1 vs Type 2 NPI<\/a> sets out which identifier a surgeon and a group practice each need, and when.<\/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>Want the diagnosis captured cleanly at the visit?<\/strong> <a href=\"https:\/\/pabau.com\/templates\/medical-diagnosis-form\/\">Medical diagnosis form<\/a> gives you a field-by-field structure that keeps the coded diagnosis matched to the note.<\/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-1786453205117\"><h3 class=\"schema-faq-question\">What does CPT code 21122 mean?<\/h3> <p class=\"schema-faq-answer\">CPT code 21122 covers a genioplasty performed with two or more sliding osteotomies of the chin. The AMA descriptor reads: Genioplasty; sliding osteotomies, 2 or more osteotomies. Surgeons use it when several cuts are needed to reposition or reshape the chin segment. A single cut is coded 21121 instead.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786453205118\"><h3 class=\"schema-faq-question\">What is the difference between CPT 21121 and CPT 21122?<\/h3> <p class=\"schema-faq-answer\">CPT 21121 describes a sliding genioplasty performed with one osteotomy, which moves the segment in a single plane. Its descriptor is Genioplasty; sliding osteotomy, single piece. CPT 21122 requires two or more osteotomies, so the surgeon can shorten, advance, or rotate the segment. The osteotomy count in the operative note decides the code. If only one cut is documented, payers downcode to 21121.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786453205119\"><h3 class=\"schema-faq-question\">How much does Medicare reimburse for CPT 21122?<\/h3> <p class=\"schema-faq-answer\">Medicare payment for CPT 21122 is set annually by the Physician Fee Schedule, and it varies by locality and place of service. Facility rates run lower than non-facility rates, because the hospital is paid separately through OPPS. Check the current figure in the CMS MPFS look-up tool for your payment year and contractor region.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786453205120\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT code 21122?<\/h3> <p class=\"schema-faq-answer\">Four modifiers come up most often. Modifier -51 applies when 21122 is co-billed with orthognathic codes such as LeFort I or BSSO. Modifier -22 covers unusual complexity that the operative note supports. Modifier -59 marks the service as distinct when NCCI edits would otherwise bundle it. Modifier -78 covers an unplanned return to the operating room after surgery. Check the current NCCI edit tables before applying any of them.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786453205121\"><h3 class=\"schema-faq-question\">Does CPT 21122 require prior authorization?<\/h3> <p class=\"schema-faq-answer\">Yes, most commercial payers and Medicare Advantage plans require prior authorization for CPT 21122. Cosmetic genioplasty is generally excluded from coverage. Functional indications may qualify, including skeletal malocclusion, post-traumatic deformity, and sleep apnea surgery. Submit the cephalometric imaging, the medical necessity narrative, and supporting diagnostic studies before scheduling.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786453205122\"><h3 class=\"schema-faq-question\">What ICD-10 codes are used with CPT 21122?<\/h3> <p class=\"schema-faq-answer\">US claims use the M26 category rather than K07, because ICD-10-CM has no K07 codes at all. The usual choices are M26.00 for an unspecified jaw size anomaly, M26.05 for macrogenia, and M26.06 for microgenia. M26.10 covers an unspecified anomaly of the jaw-cranial base relationship, and M26.4 covers unspecified malocclusion. G47.33, Q67.4, and the S02.600 fracture codes fit sleep apnea, congenital, and post-traumatic cases. Whichever you pick has to match the documented diagnosis.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786453205123\"><h3 class=\"schema-faq-question\">Is genioplasty covered by insurance under CPT 21122?<\/h3> <p class=\"schema-faq-answer\">Coverage depends on the clinical indication and the payer&#8217;s medical necessity criteria. Cosmetic genioplasty is excluded by virtually all payers. Functional cases can be covered, such as skeletal class III malocclusion needing orthognathic correction or sleep apnea surgery. The documentation has to show functional impairment and address conservative treatment. Policies vary by plan, so confirm coverage before the procedure.<\/p> <\/div> <\/div>\n","protected":false},"excerpt":{"rendered":"<p>CPT code 21122 is the billable code for a genioplasty performed with two or more sliding osteotomies of the chin. Payers read the osteotomy count in the operative note to decide whether a claim belongs here or under 21121. This guide covers the descriptor, modifier rules, 2026 fee schedule mechanics, the ICD-10-CM crosswalk, and the [&hellip;]<\/p>\n","protected":false},"author":83,"featured_media":175972,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"92","_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":[1364,4116,1543,1602,3361],"class_list":["post-175975","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-billing","tag-billing-codes","tag-clinical-documentation","tag-cpt-modifiers","tag-head-neck-surgery"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.3 (Yoast SEO v28.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT Code 21122: Genioplasty billing without downcodes 2026<\/title>\n<meta name=\"description\" content=\"CPT 21122 covers genioplasty with two or more sliding osteotomies. 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Document every cut, and use an M26 diagnosis, not K07.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21122\/\" \/>\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=\"2026-08-12T08:14:22+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-12T08:14:24+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-21122.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=\"Geschreven door\" \/>\n\t<meta name=\"twitter:data1\" content=\"Anja Dodevska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Geschatte leestijd\" \/>\n\t<meta name=\"twitter:data2\" content=\"13 minuten\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21122\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21122\\\/\"},\"author\":{\"name\":\"Anja Dodevska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#\\\/schema\\\/person\\\/f2e43b25ed02313e8781f0f4507398b9\"},\"headline\":\"CPT code 21122: Genioplasty sliding osteotomy billing guide\",\"datePublished\":\"2026-08-12T08:14:22+00:00\",\"dateModified\":\"2026-08-12T08:14:24+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21122\\\/\"},\"wordCount\":2786,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21122\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-21122.webp\",\"keywords\":[\"billing\",\"billing codes\",\"Clinical Documentation\",\"Cpt Modifiers\",\"Head neck surgery\"],\"articleSection\":[\"Billing Codes\",\"CPT Codes\"],\"inLanguage\":\"nl-NL\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21122\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21122\\\/\",\"name\":\"CPT Code 21122: Genioplasty billing without downcodes 2026\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21122\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-21122\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-21122.webp\",\"datePublished\":\"2026-08-12T08:14:22+00:00\",\"dateModified\":\"2026-08-12T08:14:24+00:00\",\"description\":\"CPT 21122 covers genioplasty with two or more sliding osteotomies. 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Whichever you pick has to match the documented diagnosis.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21122\/#faq-question-1786453205123","position":7,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-21122\/#faq-question-1786453205123","name":"Is genioplasty covered by insurance under CPT 21122?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Coverage depends on the clinical indication and the payer's medical necessity criteria. Cosmetic genioplasty is excluded by virtually all payers. Functional cases can be covered, such as skeletal class III malocclusion needing orthognathic correction or sleep apnea surgery. The documentation has to show functional impairment and address conservative treatment. Policies vary by plan, so confirm coverage before the procedure.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"}]}},"yoast":{"focus_keyword":"CPT code 21122","seo_title":"CPT Code 21122: Genioplasty billing without downcodes %%currentyear%%","meta_description":"CPT 21122 covers genioplasty with two or more sliding osteotomies. Document every cut, and use an M26 diagnosis, not K07.","content_score":"30","is_cornerstone":"","related_keyphrases":[{"keyword":"CPT code 21122 fee schedule","score":56},{"keyword":"CPT code 21122 modifiers","score":61},{"keyword":"orthognathic surgery CPT codes","score":61},{"keyword":"CPT 21122 ICD-10","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/175975","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/users\/83"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/comments?post=175975"}],"version-history":[{"count":3,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/175975\/revisions"}],"predecessor-version":[{"id":176262,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/posts\/175975\/revisions\/176262"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/media\/175972"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/media?parent=175975"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/categories?post=175975"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/nl\/wp-json\/wp\/v2\/tags?post=175975"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}