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My dental insurance denied my sinus augmentations/bone graft saying it should be billed by medical
The medical denied say code 21210 modifier 52 is not a billable code for b/c b/s of nc.
What code should a dental provider use when billing for this sinus lift?
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Hello,
Having an issue with insurance company as I had a Sinus Augmentation w/bone in preparation for a tooth implant. Dental is denying stating it should be filed under medical. What is the Medical CPT code for a Sinus Augmentation with bone? The insurance is asking for the diagnosis code which is dental to be billed using a CPT medial code. Thank you for your response.
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Hi Guest!
The most common diagnosis codes we see used for sinus lifts are:
K08.24 - Minimal atrophy of maxilla
K08.25 - Moderate atrophy of the maxilla
K08.26 - Severe atrophy of the maxilla
Hope this helps!
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What is the Diagnosis Code for Sinus Augmentation (lift) for dental implant?
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Hi Guest!
Yes minimal, moderate & severe atrophy is selected based on bone height.
As for a modifier for sinus lift, if bone substitue is used, modifier 52 for reduced services if CPT code 21210 (Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)) is being used.
Hope this helps!
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Diagnosis code for a sinus lift with implant placed how would you define minimal or moderate? does it determine on vertical
D7952 for sinus lift -is there a modifier
Thank you
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