Hi Guest!

D0367 - Cone beam CT capture with interpretation with field of view of both jaws, with or without cranium

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, and some insurers require this code to be used for CBCT (i.e. UHC). However, some medical insurers are auditing that code when used for CBCT because the description does not specify “cone beam”.

So, “76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional)” is an option to use (keep in mind you'll need to provide a narrative description for unlisted codes) We also see practices billing out for "76102 - Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urography; bilateral"


D0180 - Comprehensive Periodontal Evaluation – New or Established Patient
can be crosscoded to:
99202 - new patient level 2 evaluation & management
or
99212 - established patient level 2 evaluation & management


D6010 - surgical placement of implant body: endosteal implant
can be cross coded to:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3 or less)
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)


D7955 - Repair of Maxillofacial Soft Tissue and/or Hard Tissue Defect
can be crosscoded to:
21208 - Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)
or
21270 - Malar augmentation, prosthetic material


D6104 - bone graft at time of implant placement
can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
21215 - graft, mandibular
**use modifier -52 for reduced services when bone is not obtained from patient


D2799 - provisional crown – further treatment or completion of diagnosis necessary prior to final impression
D7210 - Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated
D6056 - prefabricated abutment - includes modification and placement

There are not direct crosscodes for extractions, crowns and abutments, 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 coding portion, be sure to code both the trauma/injury to the teeth, as well as a code that explains the accident. For example, here are some commonly used trauma/injury codes:

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
K08.411 - Partial loss of teeth due to trauma, class I
K08.412 - Partial loss of teeth due to trauma, class II
K08.413 - Partial loss of teeth due to trauma, class III
K08.414 - Partial loss of teeth due to trauma, class IV
K08.419 - Partial loss of teeth due to trauma, unspecified class

And for the wakeboarding accident, here are a few options Or if the accident happened differently, if you'd like to provide me with additional details I can offer you other coding options):
V94.31XA - Injury to rider of (inflatable) recreational watercraft being pulled behind other watercraft, initial encounter
V94.22XA - Rider of nonpowered watercraft struck by powered watercraft, initial encounter


Hope this helps!
Y93.17 - Activity, water skiing and wake boarding

Hi Jenn!

D0140 - limited oral evaluation - problem focused
can be crosscoded to:
99202 - level 2 new patient Evaluation & Management (office visit)
or
99212 - level 2 established patient Evaluation & Management (office visit)


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


D0470 - diagnostic casts
D2962 - labial veneer (porcelain laminate) - laboratory

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

There aren't any standard modifiers to use on these codes, although if the casts & veneer were performed the same date as the office visit (the 99202 or 99212), you can append the modifier 25 to the office visit code to indicate it is a separately identifiable service.


For the ICD-10 (diagnosis) codes, based on what you described, here are some coding options:
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
G89.11 - Acute pain due to trauma
W17.81XA - Fall down embankment (hill), initial encounter

Hope this helps!

Hi Guest!

D6100 - surgical removal of implant body
can be crosscoded to:
20670 - Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)
20680 - Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)


D6104 - bone graft at time of implant placement
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


D9248 - non-intravenous conscious sedation
For patients 5+ years old, can be cross coded to:
99152
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older
99153
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; each additional 15 minutes intraservice time (list separately in addition to code for primary service)


D9230 - inhalation of nitrous oxide/analgesia, anxiolysis

The code above does not have a crosscode, so you can either use the "D" code on the medical claim (many medical insurers will process the "D" code on the medical claim when they are medically necessary procedures these days), you may consider:
01999 - Unlisted anesthesia procedure(s)
And heads up, some medical insurers will consider this included in the office visit (evaluation & management code) and will not pay it separately.


D9210 - local anesthesia not in conjunction with operative or surgical procedures
depending on the substance used, may be crosscoded to:
S0020 - Injection, bupivacaine hydrochloride, 30 ml


D4265 - biologic materials to aid in soft and osseous tissue regeneration
D4266 - guided tissue regeneration - resorbable barrier, per site

The two 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!