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Guest
#1 Posted : Thursday, January 31, 2019 3:11:06 PM(UTC)
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Guest

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Hi- Im looking for a medical procedure code and diagnosis code for a 12 yo diabled boy who fell onto some poorly placed metal bleachers at an indoor sports complex and cracked 2 front teeth in half. His disability required him to have the procedure done at a children's hospital a month after the event where he was placed under general anesthesia.

Dental insurance will not pay for the hospital stay (dental proc code D9420 hosp/surg ctr calls) and it seems like something medical should pay for but they keep kicking it back to dental because of codes-- so need xref and diag code..(im thinking 99221 + K08.411 - Partial loss of teeth due to trauma, class I--???
courtneydsnow
#2 Posted : Friday, February 1, 2019 10:15:01 AM(UTC)
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courtneydsnow

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Hi Guest!

No problem, based on what you described, here are some ICD-10 diagnosis coding options for you:

S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture

It sounds like fractures from your description, but if there were teeth lost:

K08.411 - Partial loss of teeth due to trauma, class I
K08.412 - Partial loss of teeth due to trauma, class II
K08.413 - Partial loss of teeth due to trauma, class III
K08.414 - Partial loss of teeth due to trauma, class IV
K08.419 - Partial loss of teeth due to trauma, unspecified class

(if the class isn't documented/known, choose the unspecified class option)

As for the fall:

W10.8XXA - Fall (on) (from) other stairs and steps, initial encounter
W10.8XXD - Fall (on) (from) other stairs and steps, subsequent encounter
W10.8XXS - Fall (on) (from) other stairs and steps, sequela


As for hospital care CPT codes:
99221 - hospital care, new, level 1
99222 - hospital care, new, level 2
99223 - hospital care, new, level 3
99231 - hospital - subseq., level 1
99232 - hospital - subseq., level 2
99233 - hospital - subseq., level 3


Hope this helps!
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