LeFort I fracture, initial encounter for open fracture. S02.411B is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2019 edition of ICD-10-CM S02.411B became effective on October 1, 2018.
LeFort I fracture, initial encounter for closed fracture 2016 2017 2018 2019 2020 2021 Billable/Specific Code S02.411A is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2021 edition of ICD-10-CM S02.411A became effective on October 1, 2020.
A principle in all Le Fort fractures is to reestablish the premorbid dental occlusion. Portions of the pterygoid plates and associated musculature are still attached to the posterior portion of the maxilla, so passive mobilization of the fracture can be difficult.
In most cases Le Fort I fractures with bilateral comminution can easily be reduced manually. After reduction, comminuted fracture fragments need to be repositioned (in the case without defect, ie, with large fragments). If these fragmented pieces are too small they may be removed (defect cases).
A bone plate should be placed in the area where the proper vertical dimension can be determined. Other bone plates are then applied across the bone gaps which are then grafted. It is difficult to give absolute guidelines as to the strength of the plates that would be used at the bony interfaces for a Le Fort I fracture.
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ICD-10-CM Code for Fracture of tooth (traumatic) S02. 5.
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The highest forces of mastication would be in this area. Depending on the fracture pattern an L- , T-, Y-plate or a straight plate may be used.
Ensuring that the condyles are properly seated within the glenoid fossae (1), the maxillomandibular complex is rotated superiorly until the point where maximum bone contact occurs at the fracture site (2).
The plate location must take into account the tooth roots and the location of the comminuted fracture fragments to be attached to plate. Insert at least two screws on each side of the fracture line in each plate.
It is extremely rare that at least one point of bone contact across the Le Fort I level cannot be found to establish the appropriate vertical dimension. Occasionally a free bone fragment from within the Le Fort I gap can be used to provide the proper vertical dimension.
As a general principle, all facial fractures should be exposed and reduced before plating. Le Fort I fractures with bilateral comminution display the highest degree of maxillary mobility of all Le Fort fracture types.