How To Use CPT Code 21485

CPT 21485 describes the closed treatment of temporomandibular dislocation that is complicated and requires intermaxillary fixation or splinting. 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 21485?

CPT 21485 is used to describe the closed treatment of temporomandibular dislocation that is complicated and requires intermaxillary fixation or splinting. This code is used when the provider manipulates the temporomandibular joint back into its proper location and applies a fixation device to prevent movement of the jaw during the healing process.

2. Official Description

The official description of CPT code 21485 is: ‘Closed treatment of temporomandibular dislocation complicated (eg, recurrent requiring intermaxillary fixation or splinting), initial or subsequent.’

3. Procedure

When performing the closed treatment of temporomandibular dislocation, the provider begins by appropriately prepping and anesthetizing the patient. The provider then moves the mandibular condyle back into the correct position by pulling the lower jaw downward and moving the chin upward. This maneuver frees the condyle, allowing the provider to guide it back into its socket. To fix the jaw in position, arch bars are placed on the teeth, and wires are secured between the bars. The provider may also advise the patient on a modified diet to limit jaw movement and aid in the healing process.

4. Qualifying circumstances

CPT 21485 is used for patients with temporomandibular joint dislocation that is complicated and requires intermaxillary fixation or splinting. This may include cases of recurrent dislocation or dislocation that cannot be easily reduced. The procedure is performed by a qualified provider who has the necessary skills and expertise in treating temporomandibular joint dislocation.

5. When to use CPT code 21485

CPT code 21485 should be used when the provider performs the closed treatment of temporomandibular dislocation that is complicated and requires intermaxillary fixation or splinting. It is important to ensure that the specific circumstances of the dislocation meet the criteria for this code. If the dislocation does not meet the criteria, a different code may be more appropriate.

6. Documentation requirements

To support a claim for CPT code 21485, the provider must document the following information:

• Patient’s diagnosis of temporomandibular joint dislocation
• Details of the procedure performed, including the manipulation of the mandibular condyle and the application of fixation devices
• Date of the procedure
• Start and end time of the procedure
• Any additional instructions or recommendations provided to the patient
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 21485, it is important to ensure that the procedure meets the specific criteria outlined in the code description. The provider should also be aware of any additional guidelines or requirements set by the payer. It is important to accurately report the procedure and any associated services or devices provided. Additionally, it is advisable to check with the payer regarding reimbursement for temporomandibular joint appliances if the provider fits and makes their own appliances.

8. Historical information

CPT code 21485 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT 21485

There are several similar codes to CPT code 21485 that may be used in different circumstances. These include:

• CPT 21480: Closed treatment of temporomandibular dislocation, initial or subsequent
• CPT 21483: Open treatment of temporomandibular dislocation, initial or subsequent
• CPT 21490: Open treatment of temporomandibular joint fracture
• CPT 21493: Closed treatment of temporomandibular joint fracture
• CPT 21497: Open treatment of temporomandibular joint dislocation, complicated

9. Examples

1. A patient presents with a recurrent temporomandibular joint dislocation that requires intermaxillary fixation. The provider performs the closed treatment, manipulating the condyle back into place and applying fixation devices.
2. A patient experiences a temporomandibular joint dislocation that cannot be easily reduced. The provider performs the closed treatment, manipulating the condyle and applying fixation devices to stabilize the jaw.
3. A patient undergoes closed treatment for a temporomandibular joint dislocation that is complicated and requires intermaxillary fixation. The provider successfully manipulates the condyle back into its socket and secures the jaw with fixation devices.
4. A patient with a history of temporomandibular joint dislocation presents with a recurrent dislocation. The provider performs the closed treatment, manipulating the condyle and applying fixation devices to prevent further dislocations.
5. A patient sustains a temporomandibular joint dislocation that requires intermaxillary fixation due to the complexity of the dislocation. The provider performs the closed treatment, successfully reducing the dislocation and securing the jaw with fixation devices.
6. A patient presents with a temporomandibular joint dislocation that cannot be easily reduced. The provider performs the closed treatment, manipulating the condyle and applying fixation devices to stabilize the jaw and promote healing.
7. A patient with a history of temporomandibular joint dislocation experiences a recurrent dislocation. The provider performs the closed treatment, manipulating the condyle and applying fixation devices to prevent further dislocations and promote healing.
8. A patient sustains a temporomandibular joint dislocation that requires intermaxillary fixation due to the complexity of the dislocation. The provider performs the closed treatment, successfully reducing the dislocation and securing the jaw with fixation devices to aid in healing.
9. A patient presents with a temporomandibular joint dislocation that cannot be easily reduced. The provider performs the closed treatment, manipulating the condyle and applying fixation devices to stabilize the jaw and facilitate healing.