Temporomandibular Joint disorder (TMJD) is a condition that causes pain and tenderness in your jaw joints and surrounding muscles and ligaments. According to the National Institute of Dental and Craniofacial Research, as many as 10 million Americans suffer from TMJ disorders. The condition is more common among women than men. For healthcare providers, accurate documentation and coding of TMJD using the correct codes are crucial for effective treatment planning and reimbursement. Documentation must provide complete details regarding patient history, symptoms, clinical findings, diagnostic tests, and treatment plan. Medical coding outsourcing companies and professionals must stay updated on the latest guidelines to avoid costly billing errors.
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Causes and Symptoms of TMJD
There is no specific cause of this condition. It can be a result of a combination of several factors such as jaw injury (like a broken or dislocated jaw), teeth grinding or clenching (bruxism), arthritis in your jaw joint, stress and malocclusion. The symptoms depend on the specific cause and severity of the condition. Common symptoms include pain that can be felt in the face or neck, stiffness in the muscles of the jaw, limited movement of the jaw, headache, and clicking or popping sound from the TMJ site. If left untreated, the condition can lead to a wide range of complications, including chronic pain, limited chewing function and bruxism-related wear and tear.
Importance of Accurate Medical Coding for TMJD Disorders
Diagnosis of this dental condition begins with a detailed evaluation of the symptoms and analysis of the patient’s jaw condition. A wide range of diagnostic tests such as dental X-rays, CT scan and MRI scan are performed to identify issues with the jaw joint’s disk or surrounding soft tissue. Treatment methodologies include pain relievers and anti-inflammatory medications, oral splints and other surgical procedures such as arthrocentesis, corticosteroid injections, TMJ arthroscopy, modified condylotomy, injections and open-joint surgery.
Medical coding plays a critical role in the healthcare revenue cycle, ensuring that medical services related to TMJ disorder are correctly documented and reimbursed. The use of standardized codes enables healthcare providers to avoid denials due to coding errors. Medical coding services help streamline this process, reducing administrative burden for providers. Proper coding for TMJ disorders involves selecting the appropriate medical codes that correspond to diagnostic and treatment procedures.
ICD-10 Codes for TMJ Disorder
- M26.6 Temporomandibular joint disorders
- M26.60 Temporomandibular joint disorder, unspecified
- M26.601 Right temporomandibular joint disorder, unspecified
- M26.602 Left temporomandibular joint disorder, unspecified
- M26.603 Bilateral temporomandibular joint disorder, unspecified
- M26.609 Unspecified temporomandibular joint disorder, unspecified side
- M26.61 Adhesions and ankylosis of temporomandibular joint
- M26.611 Adhesions and ankylosis of right temporomandibular joint
- M26.612 Adhesions and ankylosis of left temporomandibular joint
- M26.613 Adhesions and ankylosis of bilateral temporomandibular joint
- M26.619 …… unspecified side
- M26.62 Arthralgia of temporomandibular joint
- M26.621 Arthralgia of right temporomandibular joint
- M26.622 Arthralgia of left temporomandibular joint
- M26.623 Arthralgia of bilateral temporomandibular joint
- M26.629 …… unspecified side
- M26.63 Articular disc disorder of temporomandibular joint
- M26.631 Articular disc disorder of right temporomandibular joint
- M26.632 Articular disc disorder of left temporomandibular joint
- M26.633 Articular disc disorder of bilateral temporomandibular joint
- M26.639 …… unspecified side
- M26.64 Arthritis of temporomandibular joint
- M26.641 Arthritis of right temporomandibular joint
- M26.642 Arthritis of left temporomandibular joint
- M26.643 Arthritis of bilateral temporomandibular joint
- M26.649 Arthritis of unspecified temporomandibular joint
- M26.65 Arthropathy of temporomandibular joint
- M26.651 Arthropathy of right temporomandibular joint
- M26.652 Arthropathy of left temporomandibular joint
- M26.653 Arthropathy of bilateral temporomandibular joint
- M26.659 Arthropathy of unspecified temporomandibular joint
- M26.69 Other specified disorders of temporomandibular joint
CPT Codes
- 20605 Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (e.g. temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)
- 20606 Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g. temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting
- 21010 Arthrotomy, temporomandibular joint
- 21050 Condylectomy, temporomandibular joint
- 21060 Menisectomy, partial/complete, temporomandibular joint (separate procedure)
- 21073 Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (i.e. general or monitored anesthesia care)
- 21085 Impression and custom preparation; oral surgical splint
- 21089 Unlisted maxillofacial prosthetic procedure
- 21116 Injection procedure for temporomandibular joint arthrography
- 21240 Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)
- 21242 Arthroplasty, temporomandibular joint, with allograft
- 21243 Arthroplasty, temporomandibular joint, with prosthetic joint replacement
- 21480 Closed treatment of temporomandibular dislocation; initial or subsequent
- 21485 Closed treatment of temporomandibular dislocation; complicated (e.g., recurrent requiring intermaxillary fixation or splinting), initial or subsequent
- 21490 Open treatment of temporomandibular dislocation
- 29800 Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)
- 29804 Arthroscopy, temporomandibular joint, surgical
- 70328 Radiologic exam, temporomandibular joint, open and closed mouth; unilateral
- 70330 Radiologic examination, temporomandibular joint, open and closed mouth; bilateral
- 70332 Temporomandibular joint arthrography, radiological supervision and interpretation
HCPCS Codes
- J0585 Injection, onabotulinumtoxinA, (Botox) 1 unit
- J0586 Injection, abobotulinumtoxinA, (Dysport) 5 units
- J0587 Injection, rimabotulinumtoxinB, (Myobloc) 100 units
- J0588 Injection, incobotulinumtoxinA, (Xeomin) 1 unit
- J7321 Hyaluronan or derivative, Hyalgan or Supartz, for intra-articular injection, per dose
- J7323 Hyaluronan or derivative, Euflexxa, for intra-articular injection, per dose
- J7324 Hyaluronan or derivative, Orthovisc, for intra-articular injection, per dose
- J7325 Hyaluronan or derivative, Synvisc or Synvisc-One, for intra-articular injection, 1 mg
- J7326 Hyaluronan or derivative, Gel-One, for intra-articular injection, per dose
- J7327 Hyaluronan or derivative, Monovisc, for intra-articular injection, per dose
- J7328 Hyaluronan or derivative, GELSYN-3, for intra-articular injection, 0.1 mg
- J7329 Hyaluronan or derivative, Trivisc, for intra-articular injection, 1 mg
- J7331 Hyaluronan or derivative, SYNOJOYNT, for intra-articular injection, 1 mg
- J7332 Hyaluronan or derivative, Triluron, for intra-articular injection, 1 mg
- S3900 Surface electromyography (EMG)
CDT Codes
- D7880 Occlusal orthotic device, by report
- D7881 Occlusal orthotic device adjustment
- D7899 Unspecified TMD therapy, by report
- D7999 Unspecified oral surgery procedure, by report
Medical billing and coding for TMJ disorder requires precision and expertise to ensure correct billing and claim processing. With the increasing complexity of healthcare regulations, medical coding outsourcing has become a preferred solution for many healthcare providers. Partnering with professional dental billing services ensures compliance, reduces administrative burdens, and improves revenue cycle management. By leveraging expert coding solutions, healthcare providers can focus more on delivering quality patient care while optimizing their operational efficiency.
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