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Dr Ali had to do emergency surgery on Saturday. Extremely infected tooth down to the bone. Is there a DX code for that? CPT code? Also lesion that he used lasier on. He had to extract the tooth and clean out the infection.
Much help is needed not sure how to bill
Thank you for your help
DiAnna
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Hi DiAnna!
Great question. First off - for the emergency visit:
You can certainly bill out the appropriate office visit/E&M visit code (new patients 99201-99205, or established 99211-99215), and then in addition:
99050 — Services provided in the office at time other than regularly scheduled office hours, or days when the office is closed (e.g., holidays Saturday or Sunday), in addition to basic service
Then, depending on the nature of the condition, here are some diagnosis coding options for you:
M27.2 - Inflammatory conditions of jaw
K12.2 - Cellulitis and abscess of mouth
K04.6 - Periapical abscess with sinus
K04.7 - Periapical abscess without sinus
K04.99 - Other diseases of pulp and periapical tissues
K04.01 - Reversible pulpitis
K04.02 - Irreversible pulpitis
K04.1 - Necrosis of pulp
K04.2 - Pulp degeneration
Of course you can list a code for the lesion as well, but i'll need a but more details about it :) Where was it? was it benign, malignant, or uncertain behavior?
For low level laser therapy, CPT code:
S8948 - Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes
As for other CPT code(s) - what all services were performed? extraction? anything else?
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Thank you for that information
the lesion is a aphtous ulcer in the sub lingual area
Dr. Ali extracted the lower third molar curettage infected granuloma out of mandible bone through the extracted area
then applied PRF.
Thanks Courtney
DiAnna
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi DiAnna!
No problem! Here are some additional diagnosis coding options for you based on what you described:
K12.0 - Recurrent oral aphthae
K12.1 - Other forms of stomatitis
K13.79 - Other lesions of oral mucosa
As for the CPT code for extractions, there is actually not direct crosscodes we are aware of, so you can either bill the "D" code on the medical claim (many insurers these days will process "D" codes when they are medically necessary services), or you can use the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
For the curettage & PRF:
21040 - Excision of benign tumor or cyst of mandible, by enucleation and curettage
0232T - injection(s), platelet-rich plasma, any tissue, including image guidance, harvesting and preparation when performed
Hope this helps!
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