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The procedure described by CPT® Code 21242 refers to arthroplasty of the temporomandibular joint (TMJ) utilizing an allograft. This surgical intervention is performed to address various conditions affecting the TMJ, which may include severe degeneration, ankylosis, or other pathological changes that impair function and cause pain. The procedure begins with a skin incision made in front of the ear, allowing access to the joint. Surgeons carefully navigate through the subcutaneous tissue to reach the deep temporal fascia, ensuring that critical structures, such as the temporal branch of the facial nerve, are identified and protected throughout the operation. During the arthroplasty, the TMJ space is thoroughly inspected, and any inflamed or damaged tissue is excised to promote healing and restore function. Osteophytes, which are bony growths that can develop around the joint, are also removed, and the articular cartilage is smoothed to enhance joint movement. Depending on the condition of the meniscus, it may be resected or repositioned to ensure proper joint mechanics. In cases where significant bone or fibrous tissue excision is necessary, particularly due to ankylosis, a temporal muscle and fascia flap may be created to reconstruct the joint or replace the meniscus. Alternatively, an auricular cartilage graft or an allograft can be utilized to facilitate joint reconstruction. The procedure concludes with the repair of the joint capsule and the layered closure of the overlying soft tissues, ensuring a secure and stable environment for recovery.
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The indications for performing arthroplasty of the temporomandibular joint with allograft (CPT® Code 21242) typically include the following conditions:
The procedure for arthroplasty of the temporomandibular joint with allograft involves several critical steps:
Post-procedure care following arthroplasty of the temporomandibular joint with allograft involves monitoring for complications and ensuring proper recovery. Patients may experience swelling and discomfort, which can be managed with prescribed pain relief medications. Follow-up appointments are essential to assess the healing process and the functionality of the joint. Rehabilitation exercises may be recommended to restore movement and strength in the TMJ. It is crucial for patients to adhere to the post-operative care instructions provided by their healthcare provider to optimize recovery and minimize the risk of complications.
| Short Descr | RECONSTRUCTION OF JAW JOINT | Medium Descr | ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT | Long Descr | Arthroplasty, temporomandibular joint, with allograft | 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 |
| 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). | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| Pre-1990 | Added | Code added. |
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