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#1 Posted : Thursday, December 29, 2022 9:16:46 AM(UTC)

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I am new to ICD-10 coding on dental claims, but wanted to start using them as I know we will be required to in the future.

My boss, a dentist, gave this for narrative for initial crowns on #3-4: "#3 required full coverage restoration due to large composite filling covering almost entire occlusal surface, recurrent decay, and two fractured cusps. #4 requires crown due to amalgam filling with residual decay, new decay on mesial, and a filling would be more than 2/3 width."

For applying ICD-10 codes to the dental claim, can we use K02.52 (dental caries on pit and fissure surface penetrating into dentin) and K02.62 (dental caries on smooth surface penetrating into dentin) together? This seems appropriate as there is decay on multiple surfaces, but didn't know if using both on one crown would be problematic and we should only use one code? Thank you!
#2 Posted : Thursday, January 5, 2023 2:51:30 PM(UTC)

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Hi Guest!

Great question. Yes if both of those ICD codes apply for the conditions, you can certainly use both! The way diagnosis coding works on a medical claim is that not all the diagnoses listed may apply to all services listed, there are "diagnosis pointers" to indicate to the insurer which diagnosis codes apply to which services. Sometimes all diagnosis codes listed on a claim apply to all services listed on a claim, sometimes the diagnosis codes apply to different services! It is very common to have more than 1 diagnosis code on a claim. Dental billing is not our forte here like medical coding is, but I imagine the same guidelines would apply.

Hope this helps!
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