How to Code Temporomandibular Joint Disorders Using ICD-10 Codes

How to Code Temporomandibular Joint Disorders Using ICD-10 Codes

TMJ disorders affect the jaw joint and muscles that control the jaw. The article lists the symptoms, treatment and ICD10 codes for diagnosing this condition.

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Temporomandibular joint and muscle disorders (TMJ) are a group of conditions that cause pain and dysfunction in the jaw joint and muscles that control jaw movement. The temporomandibular joint (TMJ) acts like a sliding hinge, connecting the lower jaw bone (mandible) to the skull (temporal bone) in front of the ear. Regarded as one of the most complex joints in the body, TMJ can rotate and move forward, backward and side to side.

The joint, in combination with other muscles and ligaments, allows you to chew, swallow, speak and yawn. Reports suggest that about 12 percent of people in the United States experiences TMJ disorders at any one time. In fact, women get affected more than men, with estimates suggesting 9 women to every 1 man experiencing severe pain and restricted jaw movement. Dentists providing treatment for TMJ disorders need to ensure that the medical billing and coding for the same is done appropriately on the medical claims. Dental medical coding may involve several challenges. Opting for billing services from a reliable and established dental billing company would be a practical solution.

It is often difficult to determine the exact cause of TMJ disorders. The pain may occur due to a combination of factors such as physical injury, dental surgery, autoimmune diseases, arthritis and infections. In most cases, the pain and discomfort associated with the disorder can be temporary and will resolve within a short period (usually within a couple of months).

However, in other cases the pain may be ongoing or may reoccur. Treatment modalities include medications and a host of non-drug therapies. Surgery or other procedures will be chosen as a last resort when all the conservative measures fail to deliver the expected results.

TMJ Disorders - Signs and Symptoms TMJ disorders may cause mild to debilitating symptoms, such as – 

Pain while chewing

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Tenderness of the jaw muscles

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A sudden change in the way the upper and lower teeth fit together

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Clicking, grating, or popping sounds in the jaw when you open or close your mouth

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Headache

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Limited movement or locking of the jaw

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Pain in the ear, face, jaw, and neck

Several factors that can increase the risk of TMJ disorders include - long-term (chronic) grinding or clenching of teeth, jaw injury, various types of arthritis (such as rheumatoid arthritis and osteoarthritis) and connective tissue diseases.

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How Are TMJ Disorders Diagnosed and Treated?

Initial diagnosis of this dental condition may generally begin with a detailed evaluation of symptoms. The dentist will examine the jaw in detail and observe the range of motion in the jaw, feel the jaw when the patient opens and closes mouth and press on areas around the jaw to identify sites of pain or discomfort. If the dentist suspects any specific problem, several imaging tests may be conducted – dental X -Rays (to examine the teeth or jaw), CT scan (to examine detailed images of the bones involved in the joint) and MRI (to reveal problems with the joint's disk or surrounding soft tissue). In some cases, arthroscopy is also performed to diagnose a TMJ disorder. As part of TMJ arthroscopy, a small thin tube (cannula) is inserted into the joint space, and a small camera (arthroscope) is placed in to view the area and to help determine a diagnosis.

In some cases, the symptoms of TMJ disorders may go away without treatment. However, if symptoms persist, a combination of treatment options including therapies, medications and surgical techniques will be opted. Non-drug therapies include oral splints or mouth guards (occlusal appliances), Botulinum toxin Type A injections and jaw exercises (that help strengthen, stretch and relax the jaw muscles). Medications include pain relievers and antiinflammatories, muscle relaxants and Tricyclic antidepressants. Surgery will be considered as a last resort if the above non-surgical treatment methods are not effective. Surgical techniques include Arthrocentesis, Modified condylotomy and Open-joint surgery.

Dental medical coding involves using the specific ICD-10 diagnosis codes to report various dental conditions such as TMJ disorders on the medical claims providers submit to health insurers. Dentists, orthodontists and periodontists who treat patients with TMJ disorders need to submit accurate documentation that meets payer guidelines. In addition to medical billing and coding services, dental insurance verification and pre-authorization services are crucial to verify patient’s coverage.

ICD-10 Codes for TMJ Disorders M26.6 - Temporomandibular joint disorders 

M26.60 - Temporomandibular joint disorder, unspecified

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M26.601 - Right temporomandibular joint disorder, unspecified

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M26.602 - Left temporomandibular joint disorder, unspecified

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M26.603 - Bilateral temporomandibular joint disorder, unspecified

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M26.609 - Unspecified temporomandibular joint disorder, unspecified side

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M26.61 - Adhesions and ankylosis of temporomandibular joint 

M26.611 - Adhesions and ankylosis of right temporomandibular joint

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M26.612 - Adhesions and ankylosis of left temporomandibular joint

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M26.613 - Adhesions and ankylosis of bilateral temporomandibular joint

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M26.619 Adhesions and ankylosis of temporomandibular joint, unspecified side

M26.62 - Arthralgia of temporomandibular joint 

M26.621 - Arthralgia of right temporomandibular joint

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M26.622 - Arthralgia of left temporomandibular joint

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M26.623 - Arthralgia of bilateral temporomandibular joint

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M26.629 Arthralgia of temporomandibular joint, unspecified side

M26.63 - Articular disc disorder of temporomandibular joint 

M26.631 - Articular disc disorder of right temporomandibular joint

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M26.632 - Articular disc disorder of left temporomandibular joint

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M26.633 - Articular disc disorder of bilateral temporomandibular joint

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M26.639 Articular disc disorder of temporomandibular joint, unspecified side

M26.69 - Other specified disorders of temporomandibular joint Symptoms of TMJ disorders are frequently mild and tend to cause minimal inconvenience.

Many symptoms of TMJ disorders respond well to home remedies or stress reduction and relaxation techniques. Becoming aware of habits like clenching your jaw, grinding your teeth or chewing pencils, eating soft foods and avoiding chewing gum will help reduce the occurrence of this condition to a great extent.

Medical coding for jaw bone disorders can be a challenging process. For accurate and timely medical billing and claims submission, healthcare practices can consider outsourcing their medical coding tasks to a reliable medical billing company that provides the services of AAPC-certified coding specialists.

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