Is pre-authorization required for D7852?

Pre-authorization requirements vary by insurance provider; it's advisable to check with the patient's insurer before proceeding.

Can D7852 be billed with other TMJ procedures?

Yes, D7852 can be billed with other TMJ procedures if they are performed during the same surgical session, but documentation must clearly justify each procedure.

What are common symptoms indicating the need for D7852?

Common symptoms include persistent TMJ pain, clicking sounds, and limited jaw movement due to disc perforation.

How should complications during the procedure be documented?

Any complications should be thoroughly documented in the surgical notes, including the nature of the complication and steps taken to address it.

D7852

Disc Repair - CDT Code Guide

Oral & Maxillofacial Surgery/Reduction of Dislocation and Management of Other Temporomandibular Joint Dysfunctions

Overview

CDT Code D7852 pertains to the surgical procedure of repositioning and/or sculpting the disc within the temporomandibular joint (TMJ), specifically addressing the repair of a perforated posterior attachment. This procedure is crucial for patients experiencing TMJ dysfunctions, which can manifest as pain, limited jaw movement, or clicking sounds. The surgery aims to restore normal function and alleviate discomfort by correcting disc displacement or damage. Typically, oral and maxillofacial surgeons perform this procedure in cases where conservative treatments have failed, and structural repair is necessary to improve joint mechanics and patient quality of life.

When to Use This Code

Patient presents with TMJ pain and imaging confirms disc displacement with perforation.
Conservative treatments for TMJ dysfunction have been unsuccessful, and structural repair is needed.
Patient experiences chronic TMJ clicking and pain due to a perforated posterior attachment.
Surgical intervention is required to restore normal jaw function in severe TMJ dysfunction cases.
Disc repositioning is necessary following trauma to the TMJ area.

Documentation Requirements

Detailed patient history and examination notes indicating TMJ dysfunction.
Imaging studies (e.g., MRI, CT) showing disc displacement or perforation.
Clinical notes documenting previous conservative treatments and their outcomes.
Surgical plan outlining the procedure specifics and expected outcomes.
Post-operative care instructions and follow-up plan.
Consent forms signed by the patient acknowledging understanding of the procedure.

Billing Considerations

When billing for D7852, ensure that the procedure is medically necessary and well-documented. Frequency limitations may apply, so check with the patient's insurance for coverage specifics. Common modifiers include 22 for increased procedural services if applicable. Verify if pre-authorization is required by the insurance provider to avoid claim denials.

Related CDT Codes

D7810 D7820 D7830 D7840 D7860

Frequently Asked Questions

The primary purpose is to repair a perforated disc in the TMJ to alleviate pain and restore normal jaw function.

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