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21242 - Arthroplasty, temporomandibular joint, with Pre-Service Review Required Medical Necessity Submit diagnosis, prognosis and chart

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Procedure / ServiceArthroplasty, temporomandibular joint, with Pre-Service Review Required Medical Necessity Submit diagnosis, prognosis and chart
Procedure / Service Description

documentation of medical necessity and - Fax to Dental Review @ 425-918-5956 21242 Arthroplasty, temporomandibular joint, with Pre-Service Review Required Medical Necessity Submit diagnosis, prognosis and chart allograft notes including history of non-invasive or 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.