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Jaw motion rehabilitation system

HCPCS code

Medical Policies and Guidelines for Jaw motion rehabilitation system

Related policies from health plans

Noncovered Investigational Services
Temporomandibular Disorders - Medicare Advantage
Noncovered Investigational Services(Eff. beginning 1.1.24)

Similar Codes


ICD10CM codes

R68.84 - Jaw pain
T84.310 - Breakdown (mechanical) of electronic bone stimulator
T84.320 - Displacement of electronic bone stimulator
M26.52 - Limited mandibular range of motion
T84.320A - Displacement of electronic bone stimulator, initial encounter
T84.310A - Breakdown (mechanical) of electronic bone stimulator, initial encounter
T84.310D - Breakdown (mechanical) of electronic bone stimulator, subsequent encounter
S03.0 - Dislocation of jaw
S03.03 - Dislocation of jaw, bilateral
S03.03XS - Dislocation of jaw, bilateral, sequela

HCPCS codes

E1700 - Jaw motion rehabilitation system
E1701 - Replacement cushions for jaw motion rehabilitation system, pkg. of 6
C1776 - Joint device (implantable)
E0935 - Continuous passive motion exercise device for use on knee only
L3710 - Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf
E0936 - Continuous passive motion exercise device for use other than knee
E0636 - Multipositional patient support system, with integrated lift, patient accessible controls
A9300 - Exercise equipment
E1800 - Dynamic adjustable elbow extension/flexion device, includes soft interface material
E1802 - Dynamic adjustable forearm pronation/supination device, includes soft interface material

CPT4 codes

21243 - Arthroplasty, temporomandibular joint, with prosthetic joint replacement
96000 - Comprehensive computer-based motion analysis by video-taping and 3D kinematics
69650 - Stapes mobilization
21081 - Impression and custom preparation; mandibular resection prosthesis
92611 - Motion fluoroscopic evaluation of swallowing function by cine or video recording
21010 - Arthrotomy, temporomandibular joint
77293 - Respiratory motion management simulation (List separately in addition to code for primary procedure)
70336 - Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)
21198 - Osteotomy, mandible, segmental
21089 - Unlisted maxillofacial prosthetic procedure