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Guest
#281 Posted : Friday, November 30, 2018 4:31:10 PM(UTC)
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I need to convert dental code D5982, surgical stent to a medical code as being medically necessary to prevent infection and protect the wound at the top of the mouth where they took the tissue for a gum graft so that I can submit this to our regular insurance as our dental insurance denied this coverave for this expense.

Thank you.
John Camp
Cell 713-503-1205
Email: jcmjcampjr@gmail.com
courtneydsnow
#282 Posted : Tuesday, December 4, 2018 8:35:39 AM(UTC)
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Ho John!

D5982 - surgical stent

The code listed above does not have a direct crosscode 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 try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures

Hope this helps!
Guest
#283 Posted : Wednesday, January 16, 2019 8:45:58 AM(UTC)
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I NEED THE MEDICAL CODE FOR d7286 BIOPSY OF ORAL TISSUE-SOFT
d7410 EXCISION-LESION DIAMETER TO 1.25
courtneydsnow
#284 Posted : Thursday, January 17, 2019 10:35:57 AM(UTC)
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Hi Guest!

D7286
- incisional biopsy of oral tissue-soft

Here are some CPT cross coding options for you:

40490 - Biopsy lip
40808 - Biopsy, vestibule of mouth
41108 - Biopsy of floor of mouth
41110 - Biopsy of tongue, anterior two-thirds
41105 - Biopsy of tongue, posterior one-third


D7410 - excision of benign lesion up to 1.25 cm
can be crosscoded to:

11440 excision benign lesion 0.0 to 0.5 cm
11441 excision benign lesion 0.6 to 1.0 cm
21030 removal of facial bone lesion benign
21040 removal of lesion mandible benign simple
40810 excision of lesion, vestibule
40812 excise/repair mouth lesion
40814 excise/repair vestibule lesion
40816 excision of mouth lesion complex w/muscle
41116 excision of lesion, floor of mouth


Hope this helps!
Guest
#285 Posted : Tuesday, February 12, 2019 6:07:46 PM(UTC)
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I need help converting Dental code D7410 a CDT- 10 Medical code.
Guest
#286 Posted : Tuesday, February 12, 2019 6:09:23 PM(UTC)
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I need help converting Dental code D7410 a CDT- 10 Medical code.
courtneydsnow
#287 Posted : Wednesday, February 13, 2019 6:54:13 PM(UTC)
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Hi Guest!

D7410 - excision of benign lesion up to 1.25 cm
can be crosscoded to:

11440 excision benign lesion 0.0 to 0.5 cm
11441 excision benign lesion 0.6 to 1.0 cm
21030 removal of facial bone lesion benign
21040 removal of lesion mandible benign simple
40810 excision of lesion, vestibule
40812 excise/repair mouth lesion
40814 excise/repair vestibule lesion
40816 excision of mouth lesion complex w/muscle
41116 excision of lesion, floor of mouth


Hope this helps!
Guest Niknka
#288 Posted : Wednesday, February 27, 2019 6:37:08 AM(UTC)
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I Have read all 15 pages, but could not find the medical codes for the below dental codes. Any help is appreciated

7250
4346
7310
6111
5851
courtneydsnow
#289 Posted : Thursday, February 28, 2019 9:37:59 AM(UTC)
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Hi Guest Niknka!

No problem :)

D7310 - alveoloplasty in conjunction with extractions - four or more teeth or tooth spaces, per quadrant
can be crosscoded to:
41874 - Alveoloplasty, each quadrant (specify)



D7250 - Removal of residual tooth roots (cutting procedure)
D4346 - scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation
D6111 - implant /abutment supported removable denture for edentulous arch – mandibular
D5851 - tissue conditioning, mandibular

The codes listed above do not have 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


Hope this helps!
Guest
#290 Posted : Friday, March 15, 2019 7:22:38 PM(UTC)
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I need help with d0220, d0364, d7270 for treatment of a luxated tooth with maxillary fracture. I was told follow up exams and removal of the splint also has a medical code. Any help is ajppreciated.
courtneydsnow
#291 Posted : Tuesday, March 19, 2019 7:40:07 AM(UTC)
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Hi Guest!

D0220 - intraoral - periapical first radiographic image
can be cross coded to:
70300 - Radiologic examination, teeth; single view

D0364 - Cone beam CT capture and interpretation with limited field of view - less than one whole jaw
can be cross coded to:
76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional)

D7270 - Tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth

In Aetna's crosswalk for "Oral Surgery Medical In Nature", the crosscode for D7270 is listed as:

21140 - Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)

or you can use the CPT codes below and include a narrative report describing the procedure(s):
41899 - Unlisted procedure, dentoalveolar structures


As for follow up exams, the codes are typically the established patient evaluation & management (E&M) codes 99211-99215, 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.


Hope this helps!
Guest
#292 Posted : Tuesday, June 18, 2019 10:06:07 AM(UTC)
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Hi! Could you help me with medical codes for the following:
D5820
D6549
D6205

This is as a result of a baseball to the face injury with extraction of tooth #8

Thanks!
courtneydsnow
#293 Posted : Tuesday, June 18, 2019 3:41:21 PM(UTC)
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Hi Guest!

D5820 - interim partial denture (maxillary)
D6549 - resin retainer – for resin bonded fixed prosthesis
D6205 - pontic - indirect resin based composite

The codes listed above do not have a direct crosscode 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

Same goes for the extraction as well.

As for the diagnosis code(s), here are some common ones used for trauma cases such as these:

K03.81 - Cracked tooth
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
S03.2XXA - Dislocation of tooth, initial encounter
M26.34 - Vertical displacement of fully erupted tooth or teeth
M26.33 - Horizontal displacement of fully erupted tooth or teeth
K08.531 - Fractured dental restorative material with loss of material
K08.530 - Fractured dental restorative material without loss of material


And to indicate how it happened with the baseball bat:

W21.11XA - Struck by baseball bat, initial encounter
W21.11XD - Struck by baseball bat, subsequent encounter

Hope this helps!
AdamInOhio
#294 Posted : Thursday, June 27, 2019 11:28:42 AM(UTC)
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Hi Courtney! You are so amazingly helpful with these, so I thought I would join the bandwagan. I also need assistance converting dental codes to CPT codes to re-submit a TMJ claim from a dental office to my medical provider. I have already been told they will NOT process any dental codes. I have been trying to look them up individually but thought I would just submit a message here with a list since you have been so helpful. I really appreicate it! I'll include the codes I've already found if you could verify. Thank you!

D0160 Detail/extensive oral eval, B/R Code 99205?
D0350 Oral/Facial Photographic Images Code 99070?
D0368 CT Capture, TMJ, 2+ Exposures Code 70486?
D0470 Diagnostic casts Code A4580?
D7880 Hard Guard
D7881 Jaw Relations*
D9940 Soft Guard
D9945 POSG1 *
D9945 Delivery Soft Guard *
D9946 Deliver Hard Guard *
D9947 Post Operative Hard Guard *
D9950 Occlusal analysis-mounted case
D9999 OSHA 7
D9999 OSHA 7

I also have a "TMJ consult" for my inital visit that is not listed with a code.

The items marked with a * have a $0 "fee" listed so aren't as important, but I am tryithng to make the claim as complete as possible so it will not be denied again.

Also, any advice on the best diagnosis code to use for TMD?

Thank you so much!


-Adam Allen
Cleveland, OH

Edited by user Thursday, June 27, 2019 11:31:43 AM(UTC)  | Reason: missed an item

SofiyaVel
#295 Posted : Thursday, June 27, 2019 12:38:03 PM(UTC)
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Dear Courtney,

Do we need to put Diagnose or any modifier for 00170. Oral surgeon did extraction and anesthesiologist did a sedation.

Thank you so much
courtneydsnow
#296 Posted : Thursday, June 27, 2019 12:55:52 PM(UTC)
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Hi Adam!

Thank you for the kind words!

Let's start with the diagnosis codes for Temporomandibular Joint Disorders. There is a specific set of diagnosis codes them them! Here they are below:

• M26.601 - Right temporomandibular joint disorder, unspecified
• M26.602 - Left temporomandibular joint disorder, unspecified
• M26.603 - Bilateral temporomandibular joint disorder, unspecified
• M26.609 - Unspecified temporomandibular joint disorder, unspecified side
• M26.611 - Adhesions and ankylosis of right temporomandibular joint
• M26.612 - Adhesions and ankylosis of left temporomandibular joint
• M26.613 - Adhesions and ankylosis of bilateral temporomandibular joint
• M26.619 - Adhesions and ankylosis of temporomandibular joint, unspecified side
• M26.621 - Arthralgia of right temporomandibular joint
• M26.622 - Arthralgia of left temporomandibular joint
• M26.623 - Arthralgia of bilateral temporomandibular joint
• M26.629 - Arthralgia of temporomandibular joint, unspecified side
• M26.631 - Articular disc disorder of right temporomandibular joint
• M26.632 - Articular disc disorder of left temporomandibular joint
• M26.633 - Articular disc disorder of bilateral temporomandibular joint
• M26.639 - Articular disc disorder of temporomandibular joint, unspecified side
• M26.69 - Other specified disorders of temporomandibular joint

Selecting one of the codes between M26.11-M26.69 is preferable if possible, as the first 4 listed are "unspecified"

Here's some info for possible crosscodes for the list of "D" codes you have:

D0160 - detailed and extensive oral evaluation - problem focused, by report
You're likely not looking at a 99205 for that, as that is a level 5 medical evaluation & management visit with a patient. Most dental practices we work with perform between level 1-3. So, if it is a new patient, then 99201-99203. If it is an established patient, 99211-99213.


You've got it correct on D0350 - there is not a specific CPT code available for photographs, so:
D0350 - 2D oral/facial photographic image obtained intra-orally or extra-orally
can be crosscoded to:
99070 - special supplies & materials


D0368
- Cone beam CT capture and interpretation for TMJ series including two or more exposures
There is actually not currently a specific CPT code for CBCT……the closest CPT code is: 70486 - Computed tomography, maxillofacial area; without contrast material. Many offices have been using this for some time for CBCT, however, some medical insurers are auditing that code when used for CBCT because the description does not specify “cone beam”.
76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional) is another CPT code to consider for this.


And yes you got it on D0470
D0470 - diagnostic casts
can be crosscoded to:
99070 - special supplies & materials
or
A4580 - cast supplies (e.g. plaster)
**although, please note many medical insurers consider the impressions/bite/models included in the reimbursement for the appliance for sleep & TMD and will not pay separately for them.


As for D7880 - if it is a reversible, removable appliance being used to treat TMD, some insurers who do not process "D" codes seem to be preferring 21299 which stands for: Unlisted craniofacial and maxillofacial procedure
Of course, be sure to include a narrative describing the appliance since 21299 is one of those “unlisted procedure” codes!


D7881 - Occlusal orthotic device adjustment
this service will typically be included in the evaluation & management (E&M) code (i.e. 99211, 99212 or 99213).

D9940 has actually been deleted, and replaced with:
D9944 occlusal guard – hard appliance, full arch
D9945 occlusal guard – soft appliance, full arch
D9946 occlusal guard – hard appliance, partial arch
Again on this one, there is not a specific CPT/HCPCS code available for this that we are aware of, so you will be looking at your unspecified CPT codes for those insurers who will not accept "D" codes.


D9950
- occlusion analysis - mounted case
D9999 - unspecified adjunctive procedure, by report

The code listed above does not have a direct crosscode we are aware of, so when the medical insurer doesn't accept "D" code on the medical claim, you can use the CPT codes below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


As for the "TMJ consult" for the initial visit, that would be billed under the new patient E&M codes (i.e. 99201, 99202, 99203).


Hope this helps!
courtneydsnow
#297 Posted : Thursday, June 27, 2019 1:02:27 PM(UTC)
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Hi SofiyaVel!

Great question. Yes at least 1 diagnosis code is always required when you submit medical claims. For this, the diagnosis code would be related to the condition that you are treating that requires anesthesia.

Here are some possbile modifier options for anesthesia performed by an anesthesiologist:

AA Anesthesia services performed personally by anesthesiologist
QS Monitored anesthesia care service
QX Crna service: with medical direction by a physician
QY Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist
QZ Crna service: without medical direction by a physician
23 Unusual Anesthesia

Hope this helps!
Guest
#298 Posted : Friday, June 28, 2019 10:30:54 AM(UTC)
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[quote=courtneydsnow;5200]Hi SofiyaVel!

Great question. Yes at least 1 diagnosis code is always required when you submit medical claims. For this, the diagnosis code would be related to the condition that you are treating that requires anesthesia.

Here are some possbile modifier options for anesthesia performed by an anesthesiologist:

AA Anesthesia services performed personally by anesthesiologist
QS Monitored anesthesia care service
QX Crna service: with medical direction by a physician
QY Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist
QZ Crna service: without medical direction by a physician
23 Unusual Anesthesia

Dear Courtney,

Thank you so much, That information is very useful. Can you please help with Diagnosis for dental surgical procedures?

Usually procedures are:

Surgical extraction D7210
Fully Bone Extraction D7240
courtneydsnow
#299 Posted : Friday, June 28, 2019 1:03:18 PM(UTC)
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Hi Guest!

No problem. The diagnosis code(s) to use will depend on the reason the tooth/teeth are being extracted. For example, here's a few common ones:

S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
S03.2XXA - Dislocation of tooth, initial encounter
M26.34 - Vertical displacement of fully erupted tooth or teeth
M26.33 - Horizontal displacement of fully erupted tooth or teeth
K01.1 - Impacted teeth
K01.0 - Embedded teeth


If the extractions are being performed for a different reason, let me know and I'm happy to see what type of coding options are available for it :)

Hope this helps!
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