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shemen9
#1 Posted : Thursday, November 4, 2021 4:42:40 PM(UTC)
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shemen9

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Hi,

I have a patient that fell at the public pool, hitting concrete face first. The front teeth were broken. We had to do D2394 and D8692, in order to repair and retain the teeth. What diagnostic code would be appropriate to bill for this situation?

Thank you!
courtneydsnow
#2 Posted : Thursday, November 11, 2021 2:17:30 PM(UTC)
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courtneydsnow

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Hi Shemen9!

I don’t show D8692 as a valid CDT code – what service is this code representing, or is there a typo in the code?

As for D2394 (resin-based composite - four or more surfaces, posterior)

There are not direct crosscode for this service, 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

Now, as for the diagnosis (ICD-10) codes – based on what you described, here are some coding options:

One or both of these:
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture

And this one if applicable:
G89.11 - Acute pain due to trauma

And to describe the fall:
W01.0XXA - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, initial encounter
Y92.34 - Swimming pool (public) as the place of occurrence of the external cause

Hope this helps!
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