Temporomandibular Joint Disorder
Temporomandibular joint disorder (TMJD) benefits require prior authorization, effective 01/01/2014, and medical necessity documentation plus a treatment plan listing charges for each service must be submitted and approved before treatment starts. Diagnostic x-rays, tomograms, arthrograms, cephalograms and pantograms are medically necessary for diagnosis, and CT scan or MRI is generally reserved for pre-surgical evaluations. Electromyography, kinesiography, thermography, ultrasound imaging, joint vibration analysis and computerized mandibular scans are investigational for diagnosis.