Q: If your CT reported the following injuries ““ “œRight mandibular condyle, ramus and coronoid process fracture. Complex right maxillary fracture involving the anterior, medial and lateral and superior walls (orbital floor), fracture of right pterygoid plates and orbital fractures involving the apex, lateral, superior and inferior walls with complex fractures of the frontal bone” How would you code this case ?

A This sounds like a panfacial fracture since it involves all 3 regions of the face, and it is not a LeFort. If it involves both sides of the face it would meet the definition of multiple and complex fractures for panfacial. If unilateral, you should code each fracture individually. If the frontal bone fractures are contiguous with the facial fractures you would not code them separately, but depending on how “complex” and extensive they are, you might need to code them additionally. Further description may make this equivalent to the descriptor we have for 150406.4? Frequently the radiologists call fractures complex when there are several of them, but they are not as severe as our code requires. As you can see coding complex facial fractures can be COMPLEX !!