CPT code for TMJ eminectomy

[SarahSee1114]

Does anyone know the CPT code for TMJ eminectomy? I am not finding anything in any forum or online except a lot of medical journals about the procedure. Should i use 21299 unlisted? Performed with bilateral arthroplasty 21240. Thank you!

 

[MI_CODER]

I'm not at all familiar with this procedure but I'll try my best to answer your question. I use a coding software called 3M Encoder. It leads me to 21050 when NOT performed with an arthroplasty. If it was performed with an arthroplasty, it looks like the eminectomy is included in the arthroplasty code. This makes sense because 21050 is a separate procedure code and there's a CCI edit between 21240 and 21050. Hope this helps!

Excision --> Joint Structure (Arthrectomy) --> Temporomandibular Joint --> Unspecified (partial) --> Unilateral/unspecified --> 21050

Excision --> Joint Structure (Arthrectomy) --> Temporomandibular Joint --> Associated With Arthroplasty --> (Allograft/Prosthetic Joint Replacement?) --> Other/unspecified --> (Bone/Cartilage Graft?) No --> 21240

CPT 21050 Lay Description
The physician removes the condyle of the mandible, the posterior, rounded projection on the angled branch of the jaw that articulates with the temporal bone. An incision is usually made in the skin anterior to the contour of the ear. The physician dissects the tissue layers until the condyle is exposed. The condyle is cut with drills or saws from the mandible and removed. An additional incision just under the angle of the mandible may be required. The area can be reconstructed with bone and cartilage, or a prosthetic condyle may be inserted. The skin incision is closed with layered sutures and a pressure dressing may be applied.

CPT 21240 Lay Description
The physician repairs or reconstructs the temporomandibular joint. An incision is made through the skin anterior to the contour of the ear or within the ear. The tissues are dissected and the joint is exposed. Once the joint is exposed, a variety of repairs may be performed. The articular disc may be repositioned or the ligaments may be repaired or shortened. The condylar head may be smoothed or recontoured, or the articular disc may be removed. If removed, tissue may be taken from another part of the body to replace the articular disc. The tissue may be fascia from nearby muscles such as the temporalis muscle, cartilage from the ear, dermis, or other tissues. The incisions are closed directly.

https://www.findacode.com/snomed/239533009--eminectomy-temporomandibular-joint.html#:~:text=239533009%20%2D%20Eminectomy%20temporomandibular%20joint%20%2D%20SNOMED%20CT