# TN Insurance Bulletin (1988-05-06): TN Insurance Bulletin (1988-05-06): Temporomandibular Joint Syndrome (TMJ)

> Tennessee · Agency guidance · In force

URL: https://www.frixlaw.com/law-library/statutes/TN_INS_B_19880506_5_6_88

## Section

- **Citation:** TN Insurance Bulletin (1988-05-06)
- **Heading:** TN Insurance Bulletin (1988-05-06): Temporomandibular Joint Syndrome (TMJ)
- **Jurisdiction:** Tennessee
- **Kind:** Agency guidance
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Tennessee Department of Commerce and Insurance Bulletins / TN Insurance Bulletin (1988-05-06): Temporomandibular Joint Syndrome (TMJ)

## Text

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-
STATE OF TENNESSEE
,-,"
-' ..
DEPARTMENT OF COMMERCE AND INSURANCE
1808 WEST END BUILDING
NASHVILLE. TENNESSEE 37219.5318
NED McWHERTER
ELAINE A. McREYNOLDS
GOVERNOR
COMMISSIONER
BULLETIN
TO:
ALL HEALTH INSURERS DOING BUSINESS
IN TENNESSEE
FR:
ELAINE A. MCREYNOLDS, COMMISSIONER ~t<~
DEPARTMENT OF COMMERCE AND INSURANCE
~
RE:
TEMPOROMANDIBULAR JOINT SYNDROME (TMJ)
'~'f~"!
.,
DA:
MAY 6, 1988
;
The
purpose
of
this
bulletin
is
to
announce
the
Department's
position
regarding
coverage
of
temporomandibular
joint
disorders
under
major
medical
policies.
As
you
are
aware,
TMJ
is
a
condition
involving
the
temporomandibular
joint
causing
headaches,
muscle
tenderness,
facial
pain,
and
~
other
head
and neck
pains.
Diagnosis
and
treatment
are
often
._~
multidisciplinary
in
scope.
The
question
then
arises
as
to
the
scope
of
coverage
of
TMJ
under
a
major
medical
policy
issued
in
Tennessee.
T.C.A.
Section
56-7-1002
requires
policies
issued
in
Tennessee
to
cover
surgical
procedures
or
"
other
medical
or
health
care
services
specified
in
the
policy
:i
,
which
are
within
the
scope
of
practice
of
dentistry
when
;7;
-"
performed
by a duly
licensed
dentist.
Therefore,
an accident.
and
health
policy
must
cover
treatment
of
TMJ
by
a
duly
licensed
dentist
when
such
treatment
could
also
be performed
by a physician.
;:x
-"
The
Department
has
adopted
the
American
Dental
Association
(ADA)
categorization
of
TMJ treatment
into
Phase
I
and Phase
II
treatment.
Phase
I
treatment
includes
diagnosis
and
management
of
systems.
Treatment
may
include
soft
diet,
medications,
thermal
agents,
temporary
splints,
and
voluntary
self-
disengagement
of
the
teeth
be performed
by a physician.
;:x
-"
The
Department
has
adopted
the
American
Dental
Association
(ADA)
categorization
of
TMJ treatment
into
Phase
I
and Phase
II
treatment.
Phase
I
treatment
includes
diagnosis
and
management
of
systems.
Treatment
may
include
soft
diet,
medications,
thermal
agents,
temporary
splints,
and
voluntary
self-
disengagement
of
the
teeth.
Phase
II
treatment
occurs
once
symptoms
have
subsided
and
the
patient
has been maintained
through
appliances
in
a stable
pain-free
condition
for
from
3-6
months.
Such
treatment
may
include
alteration
of
the
occlusion,
which
may be accomplished
~
through
occlusal
adjustment
of
the
teeth,
restorative
~
treatment,
prosthodontic
treatment,
orthodontic
treatment.
or
'
surgery.
,

-
r
It
is
the
Depar~ment's
position
t':\a:
Phase
I
trea:ment
.,f
~
TMJ shall
be cover~d
by accident
and health
policies.
In
addition,
surgery,
although
part
of
Phase
II
treatment,
should
also
be covered
by accident
and health
policies
when surgical
procedures
could
also
be performed
by a physician.
Policy
filings
will
be
reviewed
in
light.
of
this
announced
position.
Accordingly,
any
exclusion
of
TMJ in
a
major
medical
policy
will
not
be allowed.
Any
exclusion
of
r~~'
treatment
by a dentist
will
not
be allowed.
Coverage
cannot
;~A
be limited
to
surgical
means
only.
The Department
will
allow
~:~~
an
exclusion
for
orthodontics
or
treatment
to
the
teeth
or
~~
gums,
however,
the
Department
does
not
consider
Phase
I
treatment
to
be
treatment
to
the
teeth
or
gums.
Phase
I
treatment
of
the
temporomandibular
joint
may,
under
Phase
I
treatment,
be
accomplished
in
some
instances
through
the
application
of
devices
to
the
teeth
or
gums and would
not
be
excluded
under
an
exclusion
for
treatment
to
the
teeth
or
gums.
EAM/cmf
~.
,
.
\
~
iI
~~
tI;l
s
not
consider
Phase
I
treatment
to
be
treatment
to
the
teeth
or
gums.
Phase
I
treatment
of
the
temporomandibular
joint
may,
under
Phase
I
treatment,
be
accomplished
in
some
instances
through
the
application
of
devices
to
the
teeth
or
gums and would
not
be
excluded
under
an
exclusion
for
treatment
to
the
teeth
or
gums.
EAM/cmf
~.
,
.
\
~
iI
~~
tI;l
.
1
_:-
i
~
PAGE 2
ci
j'~~':!':
,j
;
c,

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/TN_INS_B_19880506_5_6_88. Check the current official text before relying on it. Not legal advice.