Hi Stephanie!
No problem, we are happy to help.
Starting off with the diagnosis code(s), i'll need a bit more information to offer you the most specific coding options, so a few questions for you:
1) Was the patient the driver or passenger of the bicycle, or a pedestrian hit by a bicycle?
2) If the patient was either the driver or passenger, what did they hit/run into or how did the accident happen? (did the tire blow out? ran into another bicycle or a car hit them, etc?)
3) Was the teeth shifting the only injury, or were there other issues such as broken/fractured or cracked teeth, teeth that got knocked out, laceration of the lip, etc?
The diagnosis code you list, S02.5 stands for: Fracture of tooth (traumatic)
Which only tells a portion of the story :) You will want a code that describes the accident itself, you can also use an activity code, and possibly other diagnosis codes if there were other injuries besides a traumatic fracture of tooth.
Also, S02.5 by itself is not a billable code, as there are more specific codes available, here they are below:
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
S02.5XXD - Fracture of tooth (traumatic), subsequent encounter for fracture with routine healing
S02.5XXG - Fracture of tooth (traumatic), subsequent encounter for fracture with delayed healing
S02.5XXK - Fracture of tooth (traumatic), subsequent encounter for fracture with nonunion
S02.5XXS - Fracture of tooth (traumatic), sequela
As for the medical codes for the codes you listed:
D6010 - surgical placement of implant body: endosteal implant
can be crosscoded to:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3or less)
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)
D7953 - bone replacement graft for ridge preservation - per site
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
D3310 - endodontic therapy anterior tooth (excluding final restoration)
D2950 - core buildup, including any pins when required
D2740 - crown - porcelain/ceramic substrate
D2940 - protective restoration
D5821 - interim partial denture (mandibular)
D6065 - implant supported porcelain/ceramic crown
D6057 - custom fabricated abutment - includes placement
D8040 - Limited orthodontic treatment of the adult dentition
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 try the CPT codes below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
or
99070 - Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)
Using the JO/JP qualifiers in the red shaded line of the line item in box 24j of the medical claim may help in this case as well.
The following are the codes for tooth numbers, reported with the JP qualifier:
• 1 –32: Permanent dentition
• 51 –82: Permanent supernumerary dentition
• A –T: Primary dentition
• AS –TS: Primary supernumerary dentition
The following are the codes for areas of the oral cavity, reported with the JO qualifier:
• 00 : Entire oral cavity
• 01 : Maxillary arch
• 02 : Mandibular arch
• 10 : Upper right quadrant
• 20 : Upper left quadrant
• 30 : Lower left quadrant
• 40: Lower right quadrant
Examples of how this would look on the medical claim can be found in the NUCC's CMS 1500 claim form manual here, starting on page 46 & 47:
http://www.nucc.org/imag...on_manual_2012_02-v4.pdfHere are instructions to use the JO/JP qualifiers in your DentalWriter software below:
1) In any claim in DentalWriter, double click on any line item in box 24 (or click in any white box in the line item then click the "edit service" button at the bottom of box 24) in which you wish to add the qualifiers.
2) A "procedure or service" window will appear where you can edit information on that line item. Scroll to the bottom of that window to the "supplemental information" field and type in your desired qualifier with the tooth number(s) or area of the oral cavity codes defined above, then click the "save and close" button in the upper left hand corner of the window, shown below:
3) The text you entered will appear in the red shaded line above the dates of service of the line item you selected, shown below:
Additional instructions for use of the JO and JP qualifiers is provided in the CMS 1500 claim form manual:
• When reporting tooth numbers, add in the following order: qualifier, tooth number, e.g., JP16. When reporting an area of the oral cavity, enter in the following order: qualifier, area of oral cavity code, e.g., JO10.
• When reporting multiple tooth numbers for one procedure, add in the following order: qualifier, tooth number, blank space, tooth number, blank space, tooth number, etc., e.g., JP1 16 17 32.
• When reporting multiple tooth numbers for one procedure, the number of units reported in 24G is the number of teeth involved in the procedure.
• When reporting multiple areas of the oral cavity for one procedure, add in the following order: qualifier, oral cavity code, blank space, oral cavity code, etc., e.g., JO10 20.
• When reporting multiple areas of the oral cavity for one procedure, the number of units reported in 24G is the number of areas of the oral cavity involved in the procedure.
Hope this helps, and I look forward to your response!