Is D7850 covered by dental insurance?

Coverage for D7850 depends on the patient's insurance plan. It's essential to verify benefits and obtain any necessary pre-authorizations.

Can D7850 be billed alongside other TMJ procedures?

Yes, but it may require appropriate modifiers and documentation to justify the medical necessity of each procedure.

What are the risks associated with TMJ disc excision?

Risks include infection, nerve damage, persistent pain, or limited jaw movement. Discussing these with the patient is crucial before surgery.

How do I document the necessity for a TMJ disc excision?

Include comprehensive clinical evaluations, imaging studies, and a history of failed conservative treatments in the documentation.

D7850

TMJ Disc Excision - CDT Code Guide

Oral & Maxillofacial Surgery/Reduction of Dislocation and Management of Other Temporomandibular Joint Dysfunctions

Overview

CDT Code D7850 pertains to the excision of the intra-articular disc of the temporomandibular joint (TMJ), a procedure often necessary for patients experiencing severe TMJ dysfunction. This surgical intervention involves the removal of the disc within the joint, which may be causing pain, limited movement, or other functional impairments. Typically, this procedure is considered when conservative treatments have failed to alleviate symptoms. Oral and maxillofacial surgeons perform this operation, which can significantly improve the quality of life for patients with chronic TMJ disorders. Understanding the intricacies of this procedure is crucial for both dental professionals and patients, as it involves careful assessment and precise surgical skills.

When to Use This Code

Severe TMJ dysfunction unresponsive to non-surgical treatments
Chronic pain and inflammation in the TMJ area
Mechanical derangement of the TMJ causing functional impairment
Recurrent dislocation of the TMJ
Presence of a pathological lesion within the TMJ disc

Documentation Requirements

Detailed patient history and clinical examination notes
Radiographic evidence supporting the need for disc excision
Pre-operative and post-operative clinical notes
Surgical report detailing the procedure
Patient consent forms and discussion of risks/benefits
Follow-up care instructions and progress notes

Billing Considerations

When billing for D7850, it's important to verify the patient's insurance coverage for surgical TMJ interventions, as some plans may have specific exclusions or require prior authorization. Modifiers may be necessary if the procedure is performed bilaterally or in conjunction with other TMJ surgeries. Be aware of any frequency limitations imposed by the insurance provider and ensure all documentation supports the medical necessity of the procedure.

Related CDT Codes

D7860 D7880 D7899 D7940 D7950

Frequently Asked Questions

Recovery can vary, but most patients can expect a recovery period of several weeks, with gradual improvement in function and reduction in pain.

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