How To Use CPT Code 21490

CPT code 21490 describes the open treatment of temporomandibular dislocation. 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 21490?

CPT 21490 is a code used to describe the open treatment of temporomandibular dislocation. This procedure is performed by a healthcare provider to address the dislocation of the temporomandibular joint, which causes the jaw to lock in an open position and results in significant pain and discomfort for the patient.

2. Official Description

The official description of CPT code 21490 is: ‘Open treatment of temporomandibular dislocation.’

3. Procedure

The open treatment of temporomandibular dislocation involves several steps:

1. The patient is appropriately prepped and anesthetized to ensure comfort during the procedure.
2. The healthcare provider makes an incision along the zygomatic process, or cheek, and over the ear to access the temporomandibular joint.
3. The provider then cuts into the zygomatic process to visualize the joint.
4. Using a transverse or angled incision, the provider divides the joint capsule.
5. Any loose cartilage is cleaned away, and the provider manipulates the joint back into its proper location.
6. The wound is irrigated, and the incision is closed.

4. Qualifying circumstances

CPT 21490 is used when a patient presents with a temporomandibular dislocation that requires open treatment. This procedure is typically performed by a healthcare provider who specializes in oral and maxillofacial surgery. The patient must have a documented dislocation of the temporomandibular joint, causing the jaw to lock in an open position.

5. When to use CPT code 21490

CPT code 21490 should be used when a healthcare provider performs the open treatment of temporomandibular dislocation. This code is appropriate when the provider makes an incision, manipulates the joint back into place, and closes the incision. It is important to note that CPT code 21490 should not be used for interdental wire fixation or the treatment of closed fractures of the larynx.

6. Documentation requirements

To support a claim for CPT code 21490, the healthcare provider must document the following information:

• Patient’s diagnosis of temporomandibular dislocation
• Description of the procedure performed, including the incision, manipulation of the joint, and closure of the incision
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 21490, ensure that the procedure meets the criteria for open treatment of temporomandibular dislocation. It is important to use the appropriate code based on the specific procedure performed. CPT code 21490 should not be reported with interdental wire fixation or the treatment of closed fractures of the larynx.

8. Historical information

CPT code 21490 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. Examples

1. A patient presents with a temporomandibular dislocation, and the healthcare provider performs an open treatment procedure to manipulate the joint back into place.
2. After appropriate anesthesia, the healthcare provider makes an incision, visualizes the temporomandibular joint, and manipulates it back into its proper location.
3. A patient with a locked jaw undergoes open treatment of temporomandibular dislocation, which involves making an incision, dividing the joint capsule, and manipulating the joint back into place.
4. The healthcare provider performs an open treatment procedure for a patient with a dislocated temporomandibular joint, addressing the issue through an incision and manipulation of the joint.
5. During an open treatment procedure, the healthcare provider accesses the temporomandibular joint through an incision, manipulates it back into place, and closes the incision.
6. A patient with a temporomandibular dislocation undergoes open treatment, which involves making an incision, visualizing the joint, and manipulating it back into its proper position.
7. The healthcare provider performs an open treatment procedure for a patient with a dislocated temporomandibular joint, addressing the issue through an incision and manipulation of the joint.
8. After appropriate anesthesia, the healthcare provider makes an incision, visualizes the temporomandibular joint, and manipulates it back into its proper location.
9. A patient with a locked jaw undergoes open treatment of temporomandibular dislocation, which involves making an incision, dividing the joint capsule, and manipulating the joint back into place.
10. The healthcare provider performs an open treatment procedure for a patient with a dislocated temporomandibular joint, addressing the issue through an incision and manipulation of the joint.