CPT code 97762, commonly used by dental practices to represent TMJ disorder appliance adjustments when billing medical insurance has been deleted from the CPT coding systemCPT code 97762 - Checkout for orthotic/prosthetic use, established patient, each 15 minutes – has been deleted as of January 1, 2018.
It has been replaced with: 97763 - Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes
Many dental practices treating temporomandibular disorders (TMD) have used this code in the past for follow up visits. Considering the description of the replacement code 97763, this code does not accurately describe a follow up appointment for a TMD appliance check. Many dental practices have decided to instead use the appropriate Evaluation & Management (E&M) code instead moving forward to represent these visits, for example:
99211 - Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.
99212 - Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.