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Guest
#1 Posted : Tuesday, September 6, 2022 4:06:14 PM(UTC)
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Guest

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I had a unicystic ameloblastoma biopsied and then later removed from my lower right jaw along with teeth # 26,27, & 28 and about 2” of the front lateral section of the jaw. Oral surgeon not contracted with Medicare so I submitted the claim myself with the CDT codes provided by dental office. All parts were “denied” except initial biopsy. ICD 10 = 16.5 Pre-existing conditions anxiety, depression, and dental panic disorder, ie, reason for general anesthesia. Thank you very much for any assistance! Susan Putnam knSuJich

D7285
D9222
D9223
D0330
D0140

D7451
D7140
courtneydsnow
#2 Posted : Monday, September 12, 2022 9:49:40 AM(UTC)
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courtneydsnow

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Hi Guest!

D7285 - incisional biopsy of oral tissue-hard (bone, tooth)
can be crosscoded to:
20240 - Biopsy, bone, excisional; superficial


D9222 – deep sedation/general anesthesia – first 15 minutes
and
D9223 – deep sedation/general anesthesia – each additional 15 minutes
can be crosscoded to:
00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified


D0330 - panoramic radiographic image
Can be cross coded to:
70355 - Orthopantogram (eg, panoramic x-ray)


D0140 - limited oral evaluation - problem focused
Can be cross coded to one of the following:

New patients:
99202 – 15-29 mins
99203 – 30-44 mins
99204 – 45-59 mins
99205 – 60-74 mins

Established patients:
99212 – 10-19 mins
99213 – 20-29 mins
99214 – 30-39 mins
99215 – 40-54 mins



D7451 - removal of benign odontogenic cyst or tumor - lesion diameter greater than 1.25 cm
can be crosscoded to one of the following:
21040 - Excision of benign tumor or cyst of mandible, by enucleation and/or curettage
21046 - Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])
21047 - Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])
41825 - Excision of lesion or tumor, dentoalveolar structures; without repair
41826 - Excision of lesion or tumor, dentoalveolar structures; with simple repair
41827 - Excision of lesion or tumor, dentoalveolar structures; with complex repair



D7140 - Extraction, erupted tooth or exposed root (elevation and/or forceps removal)
Extractions do not have direct crosscode - 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



For the diagnosis code, here's an option based on what you described (i am assuming it was benign because the dental procedure code D7451 describes removal of a benign tumor or cyst):
D16.5 - Benign neoplasm of lower jaw bone


Hope this helps!
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