How To Use CPT Code 21240

CPT code 21240 describes the arthroplasty of the temporomandibular joint (TMJ) with or without autograft. 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 21240?

CPT 21240 is used to describe the surgical reconstruction or replacement of the temporomandibular joint (TMJ). The TMJ is the hinge that connects the lower jaw to the temporal bone of the skull. This code includes the use of autograft, which is graft material obtained from the patient’s own body, to repair, reposition, or replace parts of the TMJ in order to improve the function of the jaw.

2. Official Description

The official description of CPT code 21240 is: ‘Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft).’

3. Procedure

During the arthroplasty of the temporomandibular joint, the provider performs a surgical reconstruction or replacement of the TMJ. The procedure involves the following steps:

1. The patient is appropriately prepped and anesthetized.
2. An incision is made over the joint area in front of the ear to expose the fascial tissue layer.
3. The provider examines the TMJ capsule, the articular disk, and the bony surfaces of the TMJ.
4. If the articular disk is healthy, it is pulled into a more normal position and sutured in place.
5. If the articular disk is abnormally stretched out, a wedge of tissue is excised from behind the disk and the edges are sutured together.
6. If the articular disk is damaged beyond repair, it is completely excised and the resulting space is filled with autograft cartilage obtained from a separate incision over the rib area.
7. The joint is irrigated, checked for bleeding, instruments are removed, and the incision is closed.

4. Qualifying circumstances

CPT 21240 is performed on patients who require surgical reconstruction or replacement of the temporomandibular joint. The procedure is indicated for individuals with TMJ dysfunction or other conditions that affect the function of the jaw. The use of autograft, obtained from the patient’s own body, may be necessary to repair or replace parts of the TMJ. The provider must assess the patient’s condition and determine the need for arthroplasty of the TMJ.

5. When to use CPT code 21240

CPT code 21240 should be used when a provider performs arthroplasty of the temporomandibular joint with or without autograft. This code is appropriate when the surgical reconstruction or replacement of the TMJ is necessary to improve the function of the jaw. It is important to accurately document the procedure and ensure that the use of autograft is clearly indicated in the medical record.

6. Documentation requirements

To support a claim for CPT code 21240, the provider must document the following information:

• Patient’s diagnosis and the need for arthroplasty of the temporomandibular joint
• Details of the procedure performed, including the use of autograft
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures or interventions performed
• Any complications or adverse events
• Signature of the provider

7. Billing guidelines

When billing for CPT code 21240, ensure that the procedure performed is arthroplasty of the temporomandibular joint with or without autograft. It is important to accurately document the use of autograft in the medical record. There are no specific guidelines regarding reporting CPT code 21240 with other codes. However, it is important to follow the appropriate coding guidelines and ensure that the documentation supports the services billed.

8. Historical information

CPT code 21240 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to CPT 21240

Five similar codes to CPT 21240 include:

• CPT 21242: Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft); with prosthetic joint replacement
• CPT 21243: Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft); with distraction
• CPT 21244: Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft); with prosthetic joint replacement and distraction
• CPT 21246: Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft); total joint replacement (includes obtaining graft)
• CPT 21247: Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft); partial joint replacement (includes obtaining graft)

9. Examples

1. A patient with severe TMJ dysfunction undergoes arthroplasty of the temporomandibular joint with autograft obtained from the rib area.
2. A patient with a history of trauma to the TMJ requires surgical reconstruction of the joint using autograft.
3. A patient with a congenital abnormality of the TMJ undergoes arthroplasty with autograft to improve jaw function.
4. A patient with chronic TMJ pain undergoes arthroplasty of the joint to alleviate symptoms and improve jaw mobility.
5. A patient with a previous failed TMJ surgery requires revision arthroplasty with autograft to correct the previous procedure.
6. A patient with a degenerative joint disease of the TMJ undergoes arthroplasty with autograft to improve joint function.
7. A patient with a TMJ disorder undergoes arthroplasty of the joint with autograft to correct the underlying issue.