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Benita
#21 Posted : Thursday, September 19, 2019 4:02:16 PM(UTC)
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Guest

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Originally Posted by: courtneydsnow Go to Quoted Post
Hi Guest!

Great question - yes the insurer may very well be looking for the crosscode. Quick question - was it your medical insurer or your dental insurer that you were looking at?


I have that same question my insurance is set up to get the approval from my medical insurance. I have the same question as this young lady as this was my coding from the dental as well.


QuoteMulti-QuoteGuest 

Posted : 2 years ago

I have a treatment plan from my periodontist to pull 4 teeth and apply bone grafts to three of them; and 6 months from now will return for dental implants. For the three teeth requiring a bone graft, they are using Codes D7210 (Extraction-surgical/erupt tooth), D7953 (Bone Replacement w/ext) and D4266 (Guided tissue regen-resorb-per). In calling my insurance carrier, and searching their site by code, it appears that the Code D7953 no longer exists. Can you tell me what procedure code should be used for Bone Replacement w/ext - are they cross-coding or coding incorrectly for what I described?

Thank you.


courtneydsnow
#22 Posted : Monday, September 23, 2019 12:48:32 PM(UTC)
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courtneydsnow

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Hi Guest!

Sorry to clarify - are you saying you're looking for the medical codes to use for extractions, bone grafts, and implants?

If so, here are some coding options below:

Bone grafts:
21210 - Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)
21215 - Graft, bone; mandible (includes obtaining graft)
**use modifier -52 for reduced services when bone is not obtained from patient

Implants:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3or less)
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)

Extractions:
Extractions 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 codes below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Hope this helps!
Guest
#23 Posted : Wednesday, June 24, 2020 8:58:40 AM(UTC)
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hi what is medical procedure for D7953 and D4266. my dentist said if converted medical insurance might pay for it
courtneydsnow
#24 Posted : Friday, June 26, 2020 12:13:01 PM(UTC)
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courtneydsnow

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Hi Guest!

D7953 - bone replacement graft for ridge preservation - per site
Can be cross coded to:
21210 - Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)
21215 - Graft, bone; mandible (includes obtaining graft)
**use modifier -52 for reduced services when bone is not obtained from patient

D4266
- guided tissue regeneration - resorbable barrier, per site
can be cross coded to:
41870 - Periodontal mucosal grafting
or
41899 - Unlisted procedure, dentoalveolar structures
**include narrative report to describe the procedure


Hope this helps!
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