How To Use CPT Code 21073

CPT code 21073 describes the therapeutic manipulation of the temporomandibular joint (TMJ) under anesthesia to relieve pain and restore movement and flexibility. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 21073?

CPT 21073 is used to describe the therapeutic manipulation of the temporomandibular joint (TMJ) under anesthesia. This procedure is performed by a healthcare provider to alleviate pain and improve the range of motion in patients with TMJ disorders. The provider administers anesthesia to reduce muscle tone and protective reflex mechanisms, allowing for effective manipulation of the joint.

2. Official Description

The official description of CPT code 21073 is: ‘Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (i.e., general or monitored anesthesia care).’ This code should not be used for TMJ manipulation without anesthesia, as there are separate codes for those procedures (97140, 98925-98929, 98943). Closed treatment of temporomandibular dislocation is also coded differently (21480, 21485).

3. Procedure

The procedure for CPT code 21073 involves the therapeutic manipulation of the temporomandibular joint under anesthesia. The patient is appropriately prepped and anesthetized, and then placed in a semi-sitting position. The healthcare provider stretches and manipulates the temporomandibular area to release joint fixations, which are points where the joint sticks due to adhesions or malalignment. In some cases, the provider may also administer fluoroscopically guided intraarticular injections with corticosteroid agents to reduce inflammation.

4. Qualifying circumstances

CPT 21073 is performed on patients with TMJ disorders who require therapeutic manipulation of the joint under anesthesia. The procedure is typically indicated for patients who have not responded to conservative treatments and continue to experience pain and limited range of motion. It is important to note that this code specifically applies to procedures performed under anesthesia, and separate codes exist for TMJ manipulation without anesthesia.

5. When to use CPT code 21073

CPT code 21073 should be used when a healthcare provider performs therapeutic manipulation of the temporomandibular joint under anesthesia. This code is appropriate for patients who have not responded to conservative treatments and require the intervention to alleviate pain and improve joint function. It is important to ensure that the procedure is performed under anesthesia, as this is a key requirement for reporting CPT code 21073.

6. Documentation requirements

To support a claim for CPT code 21073, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for therapeutic manipulation of the TMJ
• Details of the anesthesia service provided (general or monitored anesthesia care)
• Date and duration of the procedure
• Specific techniques used during the manipulation
• Any additional procedures performed, such as intraarticular injections
• Any complications or adverse events encountered
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 21073, it is important to ensure that the procedure meets the requirements for therapeutic manipulation of the TMJ under anesthesia. The anesthesia service provided should be documented and coded separately, using the appropriate anesthesia codes. It is also important to note that CPT code 21073 should not be reported if TMJ manipulation is performed without anesthesia. Additionally, be aware of any specific payer guidelines or requirements for reporting this code.

8. Historical information

CPT code 21073 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 21073

There are no similar codes to CPT code 21073.

9. Examples

1. A patient with chronic TMJ pain undergoes therapeutic manipulation of the temporomandibular joint under general anesthesia to improve joint function and alleviate pain.
2. A healthcare provider performs therapeutic manipulation of the TMJ under monitored anesthesia care for a patient with limited range of motion and difficulty eating due to TMJ disorder.
3. A patient with recurrent TMJ dislocation undergoes therapeutic manipulation of the joint under general anesthesia to correct the dislocation and improve joint stability.
4. A healthcare provider administers intraarticular injections with corticosteroid agents during therapeutic manipulation of the TMJ under anesthesia to reduce inflammation and improve treatment outcomes.
5. A patient with TMJ adhesions undergoes therapeutic manipulation of the joint under monitored anesthesia care to release the fixations and restore normal joint function.
6. A healthcare provider performs therapeutic manipulation of the TMJ under general anesthesia for a patient with severe TMJ pain and limited jaw movement.
7. A patient with TMJ malalignment undergoes therapeutic manipulation of the joint under monitored anesthesia care to correct the alignment and improve joint function.
8. A healthcare provider administers fluoroscopically guided intraarticular injections with corticosteroid agents during therapeutic manipulation of the TMJ under anesthesia to reduce inflammation and provide long-term pain relief.
9. A patient with TMJ arthritis undergoes therapeutic manipulation of the joint under general anesthesia to alleviate pain and improve joint mobility.
10. A healthcare provider performs therapeutic manipulation of the TMJ under monitored anesthesia care for a patient with TMJ disc displacement to reposition the disc and improve joint function.