CPT® Code 21240

The procedure described by CPT® Code 21240 refers to arthroplasty of the temporomandibular joint (TMJ), which is a surgical intervention aimed at restoring function and alleviating pain in the jaw joint. This procedure may be performed with or without the use of an autograft, which is a graft taken from the patient's own body. The surgery begins with a skin incision made in front of the ear, allowing access to the TMJ. The incision extends through the subcutaneous tissue to reach the superficial layer of the deep temporal fascia, which is a fibrous tissue layer that covers the muscles of the temple region. During the operation, the surgeon identifies and protects the temporal branch of the facial nerve to prevent nerve damage. The TMJ space is then exposed and inspected for any signs of inflammation or damage. If any inflamed or damaged tissue is found, it is excised to promote healing and restore joint function. Additionally, osteophytes, which are bony growths that can develop around the joint, are removed, and the articular cartilage is smoothed to enhance joint movement. In cases where the meniscus, a cartilage structure within the joint, is severely damaged, it may be resected or repositioned. If extensive excision of bone or fibrous tissue is necessary, particularly in cases of ankylosis (abnormal stiffness of the joint), a temporal muscle and fascia flap may be developed to reconstruct the joint or replace the meniscus. Alternatively, an auricular cartilage graft or an allograft (a graft from a donor) may be utilized to aid in the reconstruction process. After the reconstruction is completed, the joint capsule is repaired, and the overlying soft tissues are closed in layers to ensure proper healing. This comprehensive approach aims to restore the function of the TMJ and alleviate any associated symptoms.