2025 CPT code 21485
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Fracture and/or Dislocation Treatment Musculoskeletal System Feed
Closed treatment of a complicated temporomandibular joint dislocation, requiring intermaxillary fixation or splinting.
Modifiers may be appended to 21485 as per CPT guidelines, such as modifier 76 (repeat procedure by the same physician) if a repeat reduction is performed.Modifiers 50 (bilateral procedure) or 51 (multiple procedures) may be applicable depending on circumstances.
Medical necessity for this procedure is established by the presence of a dislocated temporomandibular joint causing significant pain, functional impairment, and potentially requiring intermaxillary fixation or splinting for proper healing and prevention of recurrence.Documentation should support the need for the chosen treatment over other less invasive options.
The physician's responsibility involves the appropriate preparation of the patient, performing the manipulation to reduce the dislocation, and applying the intermaxillary fixation or splinting device. Post-operative care and instructions to the patient regarding diet and jaw movement restrictions are also included.
In simple words: This code describes fixing a dislocated jaw that's difficult to treat, needing special methods like wiring the upper and lower jaws together or using splints to keep the jaw in place. This is done without surgery.
This CPT code encompasses the closed treatment of a temporomandibular joint (TMJ) dislocation that is considered complicated.Complicated cases often involve recurrent dislocations necessitating more extensive measures such as intermaxillary fixation (wiring the upper and lower jaws together) or splinting to stabilize the jaw and ensure proper healing.The procedure includes manipulation to reposition the dislocated jaw and the application of the fixation device.The code covers both initial and subsequent treatments for the same dislocation.
Example 1: A patient presents with a recurrent TMJ dislocation.After failed conservative management, the physician performs closed reduction and applies intermaxillary fixation with arch bars and wiring., A patient experiences a traumatic TMJ dislocation following a motor vehicle accident.The physician reduces the dislocation and applies a splint to immobilize the jaw., A patient with a history of TMJ disorders experiences a dislocation. Closed reduction is performed, and intermaxillary fixation is utilized for stabilization, followed by postoperative care including dietary modification recommendations.
Complete patient history detailing the dislocation event, including mechanism of injury and previous episodes.Pre-operative assessment and examination noting jaw alignment and range of motion. Operative report documenting reduction technique, type of fixation used, and any complications.Post-operative assessment of jaw alignment and patient’s condition. Patient education notes regarding dietary restrictions and jaw movement.
** Accurate documentation is essential for proper reimbursement.This includes thorough pre and postoperative assessments to justify the complexity of the dislocation and the need for the chosen method of fixation.
- Revenue Code: P5B (AMBULATORY PROCEDURES - MUSCULOSKELETAL)
- RVU: The relative value units (RVUs) for this code will vary depending on geographic location, facility type (e.g., hospital outpatient department versus ambulatory surgical center), and payer.Consult the appropriate fee schedule for specific values.
- Global Days: The global period for this procedure depends on the payer's guidelines. It may include the initial procedure, postoperative care, and possible follow-up appointments.Confirm with the specific payer for their definition of the global period for this code.
- Payment Status: Active
- Modifier TC rule: This procedure does not typically have a technical component (TC) modifier.
- Fee Schedule: Fee schedules for this code will vary based on payer, location, and year.Consult historical fee schedules from your specific payer for that information.
- Specialties:Oral and Maxillofacial Surgery, Emergency Medicine
- Place of Service:Office, Emergency Room - Hospital, Ambulatory Surgical Center