Advanced Search

Neurology & Pain Management Coding Alert

You Be the Coder:

Get Specific With TMJ Diagnosis for Success

Published on Tue Jan 18, 2011

Question: Our provider included two diagnoses in the documentation for a temporomandibular joint injection: TMJ pain and face pain. The Medicare LCD (local coverage determination) does not allow either diagnosis. What can we report?Answer: Many conditions can be characterized as temporomandibular disorder, so don't think your provider can only document general diagnoses such as TMJ pain (524.62) or face pain (784.0).Important: The more specific your physician can be with her diagnosis, the better. Consider these examples for diagnoses you might report for current conditions:848.1 (Jaw sprain) for strain830.0 (Closed dislocation of jaw) if the TMU or facial pain is due to recent TMJ dislocation524.69 (Temporomandibular joint disorders other specified temporomandibular joint disorders) if arthritis causes TMJ cartilage damage524.63 (Temporomandibular joint disorders articular disc disorder [reducing or non-reducing]) if TMJ disc erosion or misalignment causes the pain.Explanation: As noted in CMS guidelines, many procedures, services, or appliances used to treat TMJ [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Neurology & Pain Management Coding Alert

View All