-- Newsletters --

 

Free Tips About TMJ!

Enter your Email


TMJ and Otrthodontics

Post Surgical Orthotic / Medical Necessity

A post-surgical orthotic device is designed to allow healing of the retrodiscal tissue and stabilize the mechanism of the temporomandibular joint. The orthotic is important for rehabilitation. Without it, extreme pressure and intra-articular edema could result. Postsurgical orthotic therapy is used to position the jaw in a similar fashion as if a stabilization splint or cast were used post-operatively on a knee, hip or any other joint. The orthotic therapy is treatment to bone, cartilage, ligaments, and muscles and should be handled as a medical necessity by insurance carriers.

Orthodontics

Symptoms of headaches, facial pain, and dizziness. Objective findings included limited range of motion, muscle tenderness upon palpation (masseter, temporalis, bilateral), crepitus of the temporomandibular joint, and deviation of the jaw upon opening and closing. Maxillary and mandibular interdental fixation devices (CPT 21110) were placed to provide a stable jaw position. Treatment was not to the teeth but was orthopedic and neuromuscular in nature. Courts have ruled on similar insurance claims sent to medical insurance that “devices used to treat the patient’s condition were intended to relieve pain from the mandibular joint rather than to correct dental problems. Reasonable minds would not inevitably conclude that, as a matter of law, procedures performed were “dental services” excluded from coverage under health policy”. Because of the medical nature of the diagnosis, treatment should be considered as a medical necessity.