Overview of CPT Code 21387: Injection of therapeutic agent into temporomandibular joint

Overview of CPT Code 21387: Injection of therapeutic agent into temporomandibular joint

CPT Code 21387 refers to the injection of a therapeutic agent directly into the temporomandibular joint (TMJ) to alleviate pain and inflammation associated with TMJ disorders.

When CPT Code 21387 is Used?

This procedure is indicated in various clinical scenarios.

• Chronic pain in the temporomandibular joint.
• Inflammation or swelling of the TMJ.
• Limited jaw movement due to TMJ dysfunction.
• Osteoarthritis or rheumatoid arthritis affecting the TMJ.
• Failed conservative treatments for TMJ disorders.

Symptoms Indicating This Procedure

Patients may report several symptoms that lead to this procedure.

• Jaw pain or tenderness.
• Clicking or popping sounds when moving the jaw.
• Difficulty or pain while chewing.
• Headaches or migraines.
• Earaches or ringing in the ears.

Causes and Risk Factors

Understanding the causes and risk factors can help in managing TMJ disorders.

• Jaw injuries or trauma.
• Teeth grinding (bruxism).
• Stress leading to jaw clenching.
• Arthritis conditions.
• Misalignment of teeth or jaw.

Diagnostic Tests Before Procedure

Several diagnostic tests may be performed to guide the procedure.

• X-rays of the jaw to assess joint structure.
• MRI to evaluate soft tissue and joint function.
• CT scans for detailed imaging of the TMJ.
• Physical examination to assess jaw movement and pain.

Procedure Description

The injection procedure involves several key steps.

• Patient is positioned comfortably, and the area is cleaned.
• Local anesthesia may be administered to minimize discomfort.
• A needle is carefully inserted into the TMJ.
• The therapeutic agent, such as corticosteroids or hyaluronic acid, is injected.
• The needle is withdrawn, and pressure is applied to the injection site.

Preparation for the Procedure

Patients should follow specific guidelines before the procedure.

• Inform the doctor about any medications or allergies.
• Avoid blood thinners or anti-inflammatory medications prior to the procedure.
• Arrive with a responsible adult if sedation is used.
• Wear comfortable clothing and avoid heavy meals before the procedure.

Recovery and Aftercare

Post-procedure care is essential for optimal recovery.

• Rest the jaw and avoid hard foods for a few days.
• Apply ice packs to reduce swelling.
• Take prescribed pain medications as needed.
• Follow up with the healthcare provider for reassessment.

Possible Complications

While generally safe, there are potential risks associated with the procedure.

• Infection at the injection site.
• Bleeding or bruising.
• Increased pain or swelling.
• Allergic reaction to the injected agent.
• Nerve damage or joint damage.

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Post-Procedure Follow-Up

Regular follow-up is important for monitoring recovery.

• Initial follow-up within one week post-injection.
• Further assessments at one month and three months.
• Monitor for symptom improvement and any complications.

Alternative Treatments

There are several non-surgical options available.

• Physical therapy to strengthen jaw muscles.
• Oral splints or night guards to prevent teeth grinding.
• Medications such as NSAIDs for pain relief.
• Stress management techniques.
• Acupuncture or chiropractic care.

Home Care Tips

Patients can take steps at home to aid recovery.

• Practice gentle jaw exercises as advised.
• Use warm compresses to relax the jaw muscles.
• Maintain good posture to reduce jaw strain.
• Stay hydrated and eat soft foods.

Patient Education & Prevention

Education is key to preventing TMJ disorders.

• Avoid excessive jaw movements.
• Manage stress through relaxation techniques.
• Maintain regular dental check-ups.
• Use protective gear during contact sports.

Billing and Coding Information

CPT Code: 21387

Category: Surgical Procedures

Common Modifiers:

• 50 - Bilateral procedure
• RT - Right side
• LT - Left side

Average Cost and Insurance Coverage

Costs can vary based on location and insurance.

• Average cost ranges from $300 to $800.
• Insurance may cover part or all of the procedure.
• Check with your insurance provider for specific coverage details.

Related CPT Codes

• 20610 - 'Arthrocentesis, aspiration of joint'
• 20605 - 'Arthrocentesis, aspiration, and/or injection into a major joint or bursa'
• 20553 - 'Injection into muscle, single or multiple sites'
• 20604 - 'Arthrocentesis, aspiration of joint'

References and Sources

• Temporomandibular Joint Disorders
• Injection Therapy for TMJ Disorders
• Management of Temporomandibular Disorders