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Please Help, Dental to Medical codes desperately needed - assistance
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Guest
#1 Posted : Monday, July 25, 2016 1:38:13 PM(UTC)
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Hi, My son was in an accident 7 years ago where he lost 8 permanent teeth and broke his jaw in 3 places due to a baseball. His body has since resorbed his jaw bone and he can no longer get implants. I just paid for him to have bridges placed and am trying to get the medical codes so I can try to get some of the money applied to my deductible on my medical.

need code for:
reconstruction due to trauma (diagnosis code)

and the following D codes:
6740 tooth 6
6245 tooth 8
6245 tooth 9
6740 tooth 11

6740 tooth 22
6245 tooth 24
6245 tooth 25
6740 tooth 27

Thank you for any help.
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courtneydsnow
#2 Posted : Monday, July 25, 2016 2:16:47 PM(UTC)
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courtneydsnow

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Hi guest!

Here are some ICD-10 diagnosis coding options for the trauma due to getting hit by a baseball:

W21.03XA - Struck by baseball, initial encounter
W21.03XD - Struck by baseball, subsequent encounter
W21.03XS - Struck by baseball, sequela
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
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

As for the fracture of the mandible, there are tons to choose from, it depends on the type of fracture, here are some options for that:

S02.600A - Fracture of unspecified part of body of mandible, initial encounter for closed fracture
S02.600B - Fracture of unspecified part of body of mandible, initial encounter for open fracture
S02.600D - Fracture of unspecified part of body of mandible, subsequent encounter for fracture with routine healing
S02.600G - Fracture of unspecified part of body of mandible, subsequent encounter for fracture with delayed healing
S02.600K - Fracture of unspecified part of body of mandible, subsequent encounter for fracture with nonunion
S02.600S - Fracture of unspecified part of body of mandible, sequela

S02.609A - Fracture of mandible, unspecified, initial encounter for closed fracture
S02.609B - Fracture of mandible, unspecified, initial encounter for open fracture
S02.609D - Fracture of mandible, unspecified, subsequent encounter for fracture with routine healing
S02.609G - Fracture of mandible, unspecified, subsequent encounter for fracture with delayed healing
S02.609K - Fracture of mandible, unspecified, subsequent encounter for fracture with nonunion
S02.609S - Fracture of mandible, unspecified, sequela

S02.61XA - Fracture of condylar process of mandible, initial encounter for closed fracture
S02.61XB - Fracture of condylar process of mandible, initial encounter for open fracture
S02.61XD - Fracture of condylar process of mandible, subsequent encounter for fracture with routine healing
S02.61XG - Fracture of condylar process of mandible, subsequent encounter for fracture with delayed healing
S02.61XK - Fracture of condylar process of mandible, subsequent encounter for fracture with nonunion
S02.61XS - Fracture of condylar process of mandible, sequela

S02.62XA - Fracture of subcondylar process of mandible, initial encounter for closed fracture
S02.62XB - Fracture of subcondylar process of mandible, initial encounter for open fracture
S02.62XD - Fracture of subcondylar process of mandible, subsequent encounter for fracture with routine healing
S02.62XG - Fracture of subcondylar process of mandible, subsequent encounter for fracture with delayed healing
S02.62XK - Fracture of subcondylar process of mandible, subsequent encounter for fracture with nonunion
S02.62XS - Fracture of subcondylar process of mandible, sequela

S02.63XA - Fracture of coronoid process of mandible, initial encounter for closed fracture
S02.63XB - Fracture of coronoid process of mandible, initial encounter for open fracture
S02.63XD - Fracture of coronoid process of mandible, subsequent encounter for fracture with routine healing
S02.63XG - Fracture of coronoid process of mandible, subsequent encounter for fracture with delayed healing
S02.63XK - Fracture of coronoid process of mandible, subsequent encounter for fracture with nonunion
S02.63XS - Fracture of coronoid process of mandible, sequela

S02.64XA - Fracture of ramus of mandible, initial encounter for closed fracture
S02.64XB - Fracture of ramus of mandible, initial encounter for open fracture
S02.64XD - Fracture of ramus of mandible, subsequent encounter for fracture with routine healing
S02.64XG - Fracture of ramus of mandible, subsequent encounter for fracture with delayed healing
S02.64XK - Fracture of ramus of mandible, subsequent encounter for fracture with nonunion
S02.64XS - Fracture of ramus of mandible, sequela

S02.65XA - Fracture of angle of mandible, initial encounter for closed fracture
S02.65XB - Fracture of angle of mandible, initial encounter for open fracture
S02.65XD - Fracture of angle of mandible, subsequent encounter for fracture with routine healing
S02.65XG - Fracture of angle of mandible, subsequent encounter for fracture with delayed healing
S02.65XK - Fracture of angle of mandible, subsequent encounter for fracture with nonunion
S02.65XS - Fracture of angle of mandible, sequela

S02.66XA - Fracture of symphysis of mandible, initial encounter for closed fracture
S02.66XB - Fracture of symphysis of mandible, initial encounter for open fracture
S02.66XD - Fracture of symphysis of mandible, subsequent encounter for fracture with routine healing
S02.66XG - Fracture of symphysis of mandible, subsequent encounter for fracture with delayed healing
S02.66XK - Fracture of symphysis of mandible, subsequent encounter for fracture with nonunion
S02.66XS - Fracture of symphysis of mandible, sequela

S02.67XA - Fracture of alveolus of mandible, initial encounter for closed fracture
S02.67XB - Fracture of alveolus of mandible, initial encounter for open fracture
S02.67XD - Fracture of alveolus of mandible, subsequent encounter for fracture with routine healing
S02.67XG - Fracture of alveolus of mandible, subsequent encounter for fracture with delayed healing
S02.67XK - Fracture of alveolus of mandible, subsequent encounter for fracture with nonunion
S02.67XS - Fracture of alveolus of mandible, sequela

S02.69XA - Fracture of mandible of other specified site, initial encounter for closed fracture
S02.69XB - Fracture of mandible of other specified site, initial encounter for open fracture
S02.69XD - Fracture of mandible of other specified site, subsequent encounter for fracture with routine healing
S02.69XG - Fracture of mandible of other specified site, subsequent encounter for fracture with delayed healing
S02.69XK - Fracture of mandible of other specified site, subsequent encounter for fracture with nonunion
S02.69XS - Fracture of mandible of other specified site, sequela


As for the procedure codes you listed:


D6740 - retainer crown - porcelain/ceramic
D6245 - pontic - porcelain/ceramic

The codes listed above do not have a direct crosscode 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 try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures

Hope this helps, have a great day!
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Guest
#3 Posted : Monday, July 25, 2016 2:30:53 PM(UTC)
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I have Aetna and they said they do not have those D codes in their system. I will try the 41899 and see what happens. Do you happen to know the code for trauma due to injury?

Thank you for your help. It is much appreciated.
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courtneydsnow
#4 Posted : Monday, July 25, 2016 3:53:49 PM(UTC)
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courtneydsnow

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Hi guest!

Sorry could you clarify what you mean by "trauma due to injury"?
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