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The CPT® Code 21490 refers to the open treatment of temporomandibular dislocation, a surgical procedure aimed at addressing dislocations of the temporomandibular joint (TMJ), which connects the jawbone to the skull. This procedure is typically indicated when a dislocation occurs, causing significant pain, dysfunction, or inability to properly move the jaw. The surgery involves making an incision near or in the ear to gain access to the joint. Once the joint is exposed, the physician utilizes specialized medical instruments to rearticulate the condyle, which is the rounded end of the jawbone, back into its proper position within the joint. In cases where there is damage to the ligaments surrounding the joint, the surgeon will repair this damage to restore stability and function. After the necessary adjustments and repairs are made, the incision is then closed, completing the procedure. This intervention is crucial for patients experiencing chronic dislocations or severe symptoms that cannot be managed through conservative treatment methods.
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The open treatment of temporomandibular dislocation, as described by CPT® Code 21490, is indicated for specific conditions related to the temporomandibular joint. These indications include:
The open treatment of temporomandibular dislocation involves several critical procedural steps, which are outlined as follows:
After the open treatment of temporomandibular dislocation, patients can expect specific post-procedure care and recovery considerations. It is important for patients to follow the physician's instructions regarding pain management, which may include prescribed medications. Patients are typically advised to limit jaw movement and adhere to a soft diet during the initial recovery phase to avoid strain on the healing joint. Follow-up appointments are essential to monitor the healing process and assess the function of the temporomandibular joint. Any signs of complications, such as increased pain, swelling, or difficulty in jaw movement, should be reported to the healthcare provider promptly. Overall, the recovery period may vary depending on the individual patient's condition and the extent of the surgical intervention.
| Short Descr | OPTX TMPRMAND DISLOCATION | Medium Descr | OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION | Long Descr | Open treatment of temporomandibular dislocation | 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) | P5B - Ambulatory procedures - musculoskeletal | MUE | 1 | CCS Clinical Classification | 144 - Treatment, facial fracture or dislocation |
| 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. | LT | Left side (used to identify procedures performed on the left side of the body) |
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| 2025-01-01 | Changed | Short Description changed. |
| Pre-1990 | Added | Code added. |
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