CPT® Code 21242

The procedure described by CPT® Code 21242 refers to arthroplasty of the temporomandibular joint (TMJ) utilizing an allograft. This surgical intervention is performed to address various conditions affecting the TMJ, which may include severe degeneration, ankylosis, or other pathological changes that impair function and cause pain. The procedure begins with a skin incision made in front of the ear, allowing access to the joint. Surgeons carefully navigate through the subcutaneous tissue to reach the deep temporal fascia, ensuring that critical structures, such as the temporal branch of the facial nerve, are identified and protected throughout the operation. During the arthroplasty, the TMJ space is thoroughly inspected, and any inflamed or damaged tissue is excised to promote healing and restore function. Osteophytes, which are bony growths that can develop around the joint, are also removed, and the articular cartilage is smoothed to enhance joint movement. Depending on the condition of the meniscus, it may be resected or repositioned to ensure proper joint mechanics. In cases where significant bone or fibrous tissue excision is necessary, particularly due to ankylosis, a temporal muscle and fascia flap may be created to reconstruct the joint or replace the meniscus. Alternatively, an auricular cartilage graft or an allograft can be utilized to facilitate joint reconstruction. The procedure concludes with the repair of the joint capsule and the layered closure of the overlying soft tissues, ensuring a secure and stable environment for recovery.