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#1 Posted : Tuesday, August 27, 2019 3:57:28 PM(UTC)

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Joined: 10/16/2013(UTC)
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We performed a Frenulectomy on a patient which was causing gingival recession. I submitted to her medical insurance as procedure code 40819 and diagnosis code K06.0. However, the claim was returned as "the claim is being disallowed because the diagnosis code requires a fourth or fifth digit to provide appropriate specificity". Wondering what other code I should be using for gingival recession?

#2 Posted : Wednesday, August 28, 2019 7:49:18 AM(UTC)

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Hi jbublik!

Here they are below!

K06.010 - Localized gingival recession, unspecified
K06.011 - Localized gingival recession, minimal
K06.012 - Localized gingival recession, moderate
K06.013 - Localized gingival recession, severe
K06.020 - Generalized gingival recession, unspecified
K06.021 - Generalized gingival recession, minimal
K06.022 - Generalized gingival recession, moderate
K06.023 - Generalized gingival recession, severe

Also, diagnosis coding options for frenum issues:
Q38.1 - Ankyloglossia
Q38.0 - Congenital malformations of lips, not elsewhere classified

Hope this helps!
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