Facial Trauma in 2025 and How to Fit It into Your Otolaryngology Practice

PROGRAM DESCRIPTION: Nationwide, 23-42% of facial trauma calls are covered by otolaryngologists. Among young ENTs, trauma accounts for up to 20% of their practice. Trauma call opens the surgeon to potential surgical cases with low reimbursement that replace profitable elective surgery and tend to be disruptive to one’s practice as most are unplanned and often present late in the evening. Cases are often unscheduled and tend to go to the OR once time is available, frequently after a full day of clinical duties. Insufficient reimbursement and high opportunity costs are reported as key barriers to providing facial trauma care that may cause qualified surgeons to exclude it from their practice. From 2000 to 2021, average reimbursement for the 20 most common facial trauma procedures billed to Medicare decreased by 16.6%. Confusion over correct CPT codes persists particularly when multiple surgical approaches or fixation techniques are required.
The design of CPT codes used to log procedures for facial fractures is limited by a lack of formal indications. Inadequate documentation can directly impact collections for surgeons who may under code and are undercompensated or over code and are at risk of penalties by insurance agencies.
Between 2000 and 2019 there has been an almost twofold increase in Medicare-billed facial fracture repair services. At the same time, the discrepancy between availability of emergency and elective surgical coverage of facial trauma has engendered inefficient use of resources by burdening a few centers in the system with a disproportionate share of costly, resource-intense emergent cases.
The panel will assemble surgeons with a breadth of experience in coding facial trauma and reconstructive surgery and discuss clinical and financial trends that affect successful incorporation of CMF trauma into one’s practice. Pertinent topics include understanding coding for appropriate reimbursement for trauma repair and reconstructive procedures, compensation initiatives for overnight and weekend call, and guidelines for recognizing acuity and reducing the burden of secondary overtriage.

OUTCOME OBJECTIVE 1: Examine the variability in CPT coding for CMF trauma procedures and reduce inconsistency in billing

OUTCOME OBJECTIVE 2: Compare compensation models for facial trauma call and management

OUTCOME OBJECTIVE 3: Distinguish acuity levels of CMF trauma with the goal of recognizing the indications for immediate interfacility transfer

BACKGROUND STATEMENT: As high opportunity costs of treating CMF trauma disincentivize surgeons, we aim to promote sustainability in otolaryngology through an understanding of clinical knowledge and reimbursement that are vital to the evolution of models that will encourage participation in this necessary care.

Comprehensive Otolaryngology Track Statement :