Is prior authorization required for D7875?

Many insurance plans require prior authorization for TMJ procedures, so it's important to verify with the specific payer.

Can D7875 be billed with other TMJ procedures?

Yes, but it's crucial to use appropriate modifiers to indicate distinct procedures and avoid claim denials.

What are the common signs that a synovectomy is needed?

Persistent TMJ pain, inflammation, and dysfunction that do not respond to conservative treatments are common indicators.

How long is the recovery period after an arthroscopic synovectomy?

Recovery varies, but most patients can expect improvement in symptoms within a few weeks, with full recovery taking several months.

D7875

Arthroscopy Synovectomy - CDT Code Guide

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

Overview

CDT Code D7875 pertains to the arthroscopic synovectomy procedure, a minimally invasive surgical technique used to remove inflamed and hyperplastic synovium from the temporomandibular joint (TMJ). This procedure is often indicated for patients experiencing chronic pain, inflammation, or dysfunction in the TMJ that has not responded to conservative treatments. During the procedure, a small camera and surgical instruments are inserted into the joint space, allowing the surgeon to visualize and excise the problematic synovial tissue. This approach can lead to reduced pain and improved joint function, offering a significant benefit to patients suffering from TMJ disorders.

When to Use This Code

Patients with chronic TMJ pain unresponsive to non-surgical treatments
Cases of TMJ inflammation where synovial tissue is identified as the source
Patients with hyperplastic synovium causing joint dysfunction
Recurrent TMJ dislocation associated with synovial tissue issues
Pre-surgical evaluation suggests synovectomy as a beneficial intervention

Documentation Requirements

Detailed patient history and previous treatment attempts
Clinical notes indicating TMJ dysfunction and synovial involvement
Pre-operative imaging studies supporting the need for synovectomy
Surgical report detailing the arthroscopic procedure and findings
Post-operative care plan and follow-up instructions
Consent forms and patient education documentation

Billing Considerations

Ensure accurate documentation of the procedure and clinical necessity to support claims. Be aware of payer-specific guidelines for TMJ procedures, as some insurers may require prior authorization. Common modifiers such as -59 (distinct procedural service) may be applicable if performed in conjunction with other procedures. Frequency limitations may apply, so verify with the patient's insurance plan.

Related CDT Codes

D7880 D7899 D7999 D7810 D7820

Frequently Asked Questions

The primary benefit is the minimally invasive removal of inflamed synovial tissue, which can alleviate pain and improve joint function.

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