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The procedure described by CPT® Code 21240 refers to arthroplasty of the temporomandibular joint (TMJ), which is a surgical intervention aimed at restoring function and alleviating pain in the jaw joint. This procedure may be performed with or without the use of an autograft, which is a graft taken from the patient's own body. The surgery begins with a skin incision made in front of the ear, allowing access to the TMJ. The incision extends through the subcutaneous tissue to reach the superficial layer of the deep temporal fascia, which is a fibrous tissue layer that covers the muscles of the temple region. During the operation, the surgeon identifies and protects the temporal branch of the facial nerve to prevent nerve damage. The TMJ space is then exposed and inspected for any signs of inflammation or damage. If any inflamed or damaged tissue is found, it is excised to promote healing and restore joint function. Additionally, osteophytes, which are bony growths that can develop around the joint, are removed, and the articular cartilage is smoothed to enhance joint movement. In cases where the meniscus, a cartilage structure within the joint, is severely damaged, it may be resected or repositioned. If extensive excision of bone or fibrous tissue is necessary, particularly in cases of ankylosis (abnormal stiffness of the joint), a temporal muscle and fascia flap may be developed to reconstruct the joint or replace the meniscus. Alternatively, an auricular cartilage graft or an allograft (a graft from a donor) may be utilized to aid in the reconstruction process. After the reconstruction is completed, the joint capsule is repaired, and the overlying soft tissues are closed in layers to ensure proper healing. This comprehensive approach aims to restore the function of the TMJ and alleviate any associated symptoms.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 21240 is indicated for various conditions affecting the temporomandibular joint (TMJ). These indications may include:
The procedure for arthroplasty of the temporomandibular joint involves several critical steps, which are detailed as follows:
After the arthroplasty of the temporomandibular joint, patients can expect a recovery period that may involve pain management and physical therapy to restore function. Post-operative care typically includes monitoring for any signs of infection, managing swelling, and following specific instructions regarding diet and activity levels. Patients may be advised to avoid hard or chewy foods during the initial recovery phase to prevent strain on the healing joint. Follow-up appointments will be necessary to assess healing and the effectiveness of the procedure, as well as to make any adjustments to the rehabilitation plan as needed.
| Short Descr | RECONSTRUCTION OF JAW JOINT | Medium Descr | ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT | Long Descr | Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P3D - Major procedure, orthopedic - other | MUE | 1 | CCS Clinical Classification | 154 - Arthroplasty other than hip or knee |
| RT | Right side (used to identify procedures performed on the right side of the body) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | GW | Service not related to the hospice patient's terminal condition | LT | Left side (used to identify procedures performed on the left side of the body) |
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| Pre-1990 | Added | Code added. |
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