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Guest
#21 Posted : Monday, April 22, 2019 3:57:47 PM(UTC)
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If you don’t mind helping with diagnosis codes too I would really appreciate it.
courtneydsnow
#22 Posted : Tuesday, April 23, 2019 10:20:58 AM(UTC)
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Hi Guest!

No problem.

For the trauma, you're likely looking at:

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


There will also be a code to describe how to accident happened. Depending on the details of how it happened, here are some coding options:

- W01.0XXA - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, initial encounter
- W01.198A - Fall on same level from slipping, tripping and stumbling with subsequent striking against other object, initial encounter
- W03.XXXA - Other fall on same level due to collision with another person, initial encounter
- W18.01XA - Striking against sports equipment with subsequent fall, initial encounter


And a few to identify where it happened:

Y92.39 - Other specified sports and athletic area as the place of occurrence of the external cause
Y92.310 - Basketball court as the place of occurrence of the external cause
Y92.311 - Squash court as the place of occurrence of the external cause
Y92.312 - Tennis court as the place of occurrence of the external cause
Y92.318 - Other athletic court as the place of occurrence of the external cause
Y92.320 - Baseball field as the place of occurrence of the external cause
Y92.321 - Football field as the place of occurrence of the external cause
Y92.322 - Soccer field as the place of occurrence of the external cause
Y92.328 - Other athletic field as the place of occurrence of the external cause


Hope this helps!
Guest
#23 Posted : Tuesday, February 18, 2020 4:25:08 PM(UTC)
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Isn't the CPT code for Alveolar Ridge Fracture 21440; not 21140? 21140 is not in any of my coding books currently. I am coding for fracture repair with teeth stabilization. the teeth were luxated; not subluxed; not evulsed. D codes are either D7620 which really only crosses over to LeForte fractures and so isn't really accurate for Alveolar Ridge so I am thinking the D7670- alveolus; includes stabilization. BUT...D7270 is for teeth reimplantation and/OR (or being key word) - stabilization of evulsed OR displaced tooth (luxated = Displaced)


We simply placed arch bars to reduce fracture and restabalize teeth.

I am needing to file Medical first as Dental requires medical eob.
courtneydsnow
#24 Posted : Wednesday, February 19, 2020 9:03:58 AM(UTC)
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Hi Guest!

Yes 21140 is not a valid CPT code, that was a typo on my part! Thank you for pointing that out so i can correct that post!

21440 stands for:
Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)

Gaylen
#25 Posted : Tuesday, July 7, 2020 5:46:01 PM(UTC)
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Hi I'm looking for the corresponding medical codes (Diagonsistic & Procedure) for the following dental codes:

D4266 Guided Tiss Regen-resorb-per
D7951 Sinus Augmentation w/bone

If you could help me, i would really appreciate it.

Signed
a tired patient trying to get this resolved.
courtneydsnow
#26 Posted : Wednesday, July 8, 2020 8:22:26 AM(UTC)
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Hi Gaylen!


D7951 - sinus augmentation with bone or bone substitutes via a lateral open approach
can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
*use -52 modifier for reduced services when bone is not obtained from the patient


D4266 - guided tissue regeneration - resorbable barrier, per site

There is not a direct crosscode available for this service, so if the medical insurer will not accept the "D" code on the medical claim (many will these days when they are medically necessary procedures), or you can use the code below and include narrative report to describe the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Now, as for the diagnostic code(s) - that will depend on why these services performed, or basically, what issues/condition(s) are being treated?

For example, if there is atrophy of the maxilla (upper jaw):

K08.24 - Minimal atrophy of maxilla
K08.25 - Moderate atrophy of the maxilla
K08.26 - Severe atrophy of the maxilla


Hope this helps!
Guest
#27 Posted : Thursday, August 18, 2022 4:09:14 PM(UTC)
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Hello, we have a patient that was in a car accident and broke most of his front teeth. The dental code used was D2740 and D2950, D0350,D6750,D6245, D9944. We need to try to get the medical codes to replace the dental, so we may file with the medical company. Sorry for so many of the codes. Thank you in advance.

Glenda
courtneydsnow
#28 Posted : Wednesday, August 24, 2022 1:53:00 PM(UTC)
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Hi Glenda!


D2740 - crown - porcelain/ceramic
D2950 - core buildup, including any pins when required
D0350 - 2D oral/facial photographic image obtained intra-orally or extra-orally
D6750 - retainer crown - porcelain fused to high noble metal
D6245 - pontic - porcelain/ceramic
D9944 - occlusal guard – hard appliance, full arch


The codes listed above do not have direct crosscodes we are aware of - 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!
Guest
#29 Posted : Thursday, September 22, 2022 1:09:58 PM(UTC)
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Hi,

My son had an accident, and his two front teeth were fractured. We have been having a two-year battle trying to get his claim paid.
The billing dept. of our dentist office said they cannot convert the dental codes into a medical codes. I am lucky I found this forum.

I need the below dental codes converted into CPT medical codes.

I have viewed a few already but want to double check.

D0140 = CPT99201 (new pt.) or CPT 99212 (est. pt.)
D0220 = CPT70300 (radiologic examination teeth single view)
D3310 = CPT41899 (unlisted procedure dentoalveolar structures)
D2740 = CPT41899 (unlisted procedure dentoalveolar structures)
D9944 = CPT41899 (unlisted procedure dentoalveolar structures)
D9230 =
D0270 =
D2954 =
D9230 =

Thank you
courtneydsnow
#30 Posted : Tuesday, September 27, 2022 8:23:47 AM(UTC)
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courtneydsnow

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Hi Guest!

You are correct on the crosscodes you already listed, and here are the remaining:

D0270 - bitewing - single radiographic image
can be cross coded to:
70300 - Radiologic examination, teeth; single view


D9230 - inhalation of nitrous oxide/analgesia, anxiolysis

D9230 does not have a crosscode, so since it sounds like your medical insurer is not accepting 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.


D2954 - prefabricated post and core in addition to crown

There are not direct crosscodes we are aware of for the procedures listed above, so you can either use 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.



And since this is an accident case, you will want to provide ICD-10 diagnosis codes that describe the trauma to teeth, pain if present, and how the accident happened:

For the fractured teeth:
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture

If there was acute pain:
G89.11 - Acute pain due to trauma

And as for the code to describe how the accident happened, if you'd like to reply with some details about the accident i'm happy to offer you some coding options. There are codes for vehicle accidents, sports accidents, fights, falls, etc etc etc.


Hope this helps!
Guest
#31 Posted : Saturday, October 1, 2022 3:25:26 PM(UTC)
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Can you please help me get CPT or medical codes for procedures of bone grafting as well as implants and dentures? My son needs a bone grafting procedure with implants to follow along with dentures due to his genetic medical condition. We were told to go through our medical insurance bc it’s due to his medical condition he needs these procedures and prosthesis. I need to appeal to insurance for pre approval. We have to work with 2 different medical professionals, one being a prosthodontist and the other an oral surgeon. Appreciate any and all help please!
courtneydsnow
#32 Posted : Friday, November 11, 2022 12:21:02 PM(UTC)
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courtneydsnow

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Hi Guest!

Absolutely:

For the 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


For the implants:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial
21249 - 21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)


Dentures do not have a direct crosscode - so you can either bill the "D" code (dental 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!
Guest
#33 Posted : Tuesday, November 22, 2022 12:35:00 PM(UTC)
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My child has a repaired cleft palate and has had surgeries through the craniofacial department at Children's in Seattle. She received braces when she turned 14 through their dental department. Our insurance supposedly covers this cost since she it is part of her craniofacial treatment. However, Children's billed out insurance with dental codes that our insurance will not accept. They are asking for medical codes, but Children's uses the D8080 dental code. Is there a medical code conversion? We have been battling this claim for two years. Sadly, she needs braces put on again next year and we haven't paid for the first set.
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