Prior Auth Required

21073 - Manipulation of temporomandibular joint(s) Pre-Service Review Required Medical Necessity Submit diagnosis, prognosis and chart

This procedure appears on the selected insurer prior authorization source.

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Procedure / ServiceManipulation of temporomandibular joint(s) Pre-Service Review Required Medical Necessity Submit diagnosis, prognosis and chart
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - Fax to Dental Review @ 425-918-5956 21073 Manipulation of temporomandibular joint(s) Pre-Service Review Required Medical Necessity Submit diagnosis, prognosis and chart (TMJ), therapeutic, requiring an anesthesia notes including history of non-invasive or service (ie, general or monitored non-surgical attempts to treat the TMJ.

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.