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M26.60
ICD-10-CM
Temporomandibular Joint Dysfunction

Find information on Temporomandibular Joint Dysfunction diagnosis, TMJ ICD 10 code, and clinical documentation requirements. Learn about TMD treatment, TMJ symptoms, and medical coding for TMJ disorders. Explore resources for healthcare professionals on temporomandibular joint pain, jaw pain, and TMJ dysfunction management. This resource provides guidance on proper coding and documentation for TMJ related diagnoses in medical records.

Also known as

TMJ Dysfunction
TMJ Disorder
Temporomandibular Disorder

Diagnosis Snapshot

Key Facts
  • Definition : Disorder of the jaw joint and surrounding muscles causing pain, clicking, and limited movement.
  • Clinical Signs : Jaw pain, headaches, earaches, clicking or popping jaw, difficulty chewing, limited jaw opening.
  • Common Settings : Dentist, Oral Surgeon, Orofacial Pain Specialist, Physical Therapist

Related ICD-10 Code Ranges

Complete code families applicable to AAPC M26.60 Coding
M26.6

TMJ disorders

Covers temporomandibular joint dysfunction and related disorders.

K07.6

Dentofacial anomalies incl. malocclusion

May contribute to or be associated with TMJ dysfunction.

M79.1

Myalgia

Muscle pain, including masticatory muscles, may be a symptom of TMJ issues.

F45.4

Somatization disorder

In some cases, TMJ pain might be related to somatization.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the TMJ dysfunction related to arthritis?

  • Yes

    Is it due to rheumatoid arthritis?

  • No

    Is there derangement of the TMJ disc?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Jaw pain and clicking
Myofascial pain syndrome
Osteoarthritis of TMJ

Documentation Best Practices

Documentation Checklist
  • Document chief complaint related to TMJ
  • Record TMJ exam findings: palpation, ROM, clicking
  • Note pain location, quality, intensity, duration
  • Include diagnostic imaging results if performed
  • Specify TMJ dysfunction type/severity if known

Coding and Audit Risks

Common Risks
  • Unspecified TMJ laterality

    Coding TMJ dysfunction without specifying laterality (right, left, or bilateral) when documented can lead to claim denials or inaccurate data.

  • TMJ disc displacement vs. other

    Confusing disc displacement with other TMJ disorders like arthralgia or myalgia can affect coding accuracy and reimbursement.

  • Missing TMJ etiology documentation

    Lack of documentation specifying traumatic, degenerative, or other causes for TMJ dysfunction makes accurate coding difficult, impacting data quality and compliance.

Mitigation Tips

Best Practices
  • Accurate ICD-10 coding (M26.6) for TMD ensures proper reimbursement.
  • Detailed clinical documentation supports medical necessity for TMD treatment.
  • Regular TMD screenings aid early diagnosis, improving patient outcomes.
  • Timely CDI for TMD optimizes healthcare resource allocation and compliance.
  • Interprofessional collaboration enhances TMD management and coding accuracy.

Clinical Decision Support

Checklist
  • 1. Verify pain/discomfort: Jaw, face, ear, temple. Document location.
  • 2. Check for jaw clicking/popping: Palpate TMJ during movement.
  • 3. Assess jaw range of motion: Limited opening, deviation? Measure/document.
  • 4. Evaluate for tenderness: Palpate masticatory muscles. Document findings.

Reimbursement and Quality Metrics

Impact Summary
  • Temporomandibular Joint Dysfunction Reimbursement: ICD-10-CM M26.6, CPT 99202-99215 (Evaluation and Management), Splint fabrication D7999. Accurate coding maximizes reimbursement.
  • Coding accuracy impact: Miscoding TMJ disorders (e.g., using M26.63 for initial encounter) leads to claim denials, impacting revenue cycle.
  • Quality metrics impact: Tracking TMJ diagnosis codes (M26.6x) allows for population health management and quality improvement initiatives.
  • Hospital reporting impact: Accurate TMJ coding (M26.6, associated procedures) crucial for precise hospital reporting, resource allocation.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code TMJ pain ICD-10 M26.8
  • Document TMJ clicks, pops, limitations
  • Laterality: specify right, left, or bilateral TMJ
  • Consider coding for bruxism, if present
  • Check medical necessity for imaging: ICD-10 codes

Documentation Templates

Patient presents with complaints consistent with temporomandibular joint dysfunction (TMD), characterized by  jaw pain, temporomandibular joint pain (TMJ pain), and limited jaw movement.  Symptoms include clicking jaw, popping jaw, and difficulty chewing.  Onset of symptoms was reported as [onset timeframe - e.g., two weeks ago] and is associated with [possible precipitating factors - e.g., stress, teeth grinding (bruxism)].  Physical examination reveals [specific findings - e.g., tenderness to palpation of the TMJ, crepitus upon jaw opening, limited range of motion (ROM) of the mandible, pain with lateral jaw movement].  Assessment includes differential diagnosis considerations such as myofascial pain syndrome, ear infection, and dental issues.  The diagnosis of TMD is supported by the patient's reported symptoms and clinical findings.  Treatment plan includes [conservative management strategies - e.g., patient education on jaw exercises, self-care strategies such as moist heat application, soft diet recommendations] and referral to [specialist if applicable - e.g., oral and maxillofacial surgeon, physical therapist specializing in TMD] for further evaluation and management as indicated.  Follow-up scheduled in [timeframe - e.g., two weeks] to assess response to treatment and adjust the plan as necessary.  ICD-10 code M26.63 (Temporomandibular joint disorders) is assigned.
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