CPT® Code 21073

Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)

A therapeutic temporomandibular joint (TMJ) manipulation is a specialized procedure aimed at addressing various disorders associated with the TMJ, which is the joint connecting the jawbone to the skull. This manipulation is performed under the influence of anesthesia, which can be either general anesthesia or monitored anesthesia care, ensuring that the patient remains comfortable and pain-free throughout the procedure. The primary goal of TMJ manipulation is to alleviate symptoms such as clicking and popping sounds in the joint, pain experienced in the jaw area, and restricted movement of the jaw. During the procedure, a local anesthetic is also administered directly to the temporomandibular joint, targeting the surrounding muscles, including the masseter, temporalis, medial pterygoid, and lateral pterygoid muscles, as necessary. This dual approach of using both general or monitored anesthesia and local anesthetic helps to ensure that the patient does not experience discomfort during the manipulation process. Once adequate local anesthesia is achieved, the clinician performs manual manipulation of the jaw. The initial step involves moving the mandible backward (posteriorly) and holding it in that position. Following this, the jaw is gradually manipulated downward (inferiorly) and then moved side-to-side. This series of movements is designed to open the joint space, thereby enhancing the range of motion of the jaw. The clinician evaluates the range of motion throughout the procedure and may repeat the manipulation as needed until the maximum range of motion is attained and any joint clicking is resolved. This comprehensive approach to TMJ manipulation aims to restore normal function and alleviate discomfort associated with TMJ disorders.