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CS
#1 Posted : Sunday, March 7, 2021 12:05:46 PM(UTC)
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Guest

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#6 tooth pushed backwards & broke #10. Everything has been ASAP. I checked with my medical insurance & they told me everything was covered due to it being an accident. They told me all I needed was to have tax id's, codes, receipts & dates to file the claims myself, which I did. After the root canal, I was told I needed medical procedure & diagnosis codes, not dental codes, and I needed pre-authorization.

I need help finding 2021 procedure & diagnosis medical codes for the following dental codes.

D0140 (5 minute Consultation) (Diagnosis-Pull tooth back into place & Brace -ASAP)
D0140 (5 minute Consultation) (Diagnosis-Pulled 3/4 broken tooth out of gum)
D9310 (Consult-Per Session) (Diagnosis- straighten tooth & brace)
D9430 (Office Visit co-pay -brace)
D0330 (Panoramic XRAY -brace)
D4321 (PROV Splint EXTRACO)(Multiple & ASAP)
D0220 (Periapical 1st XRAY -brace)
D0460 (Pulp Vitality tests) (Diagnosis-Damaged roots/blood vessels)
D3310 (Root Canal ANTE) (Diagnosis-Infected)

I also need codes for crowns, and implants.

courtneydsnow
#2 Posted : Monday, March 8, 2021 10:12:04 AM(UTC)
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courtneydsnow

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Hi C S!

Let's start with the diagnosis coding for this case. I recommend you confirm these with your provider, however based on what you described, here are some ICD-10 coding options for you:

S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
S03.2XXA - Dislocation of tooth, initial encounter
G89.11 - Acute pain due to trauma
W00.0XXA - Fall on same level due to ice and snow, initial encounter


As for the procedure codes:

D0140 - limited oral evaluation - problem focused
D9310 - consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician
D9430 - Office visit for observation (during regularly scheduled hours) - no other services performed
can be crosscoded to:
99202 - level 2 new patient Evaluation & Management (office visit)
or
99212 - level 2 established patient Evaluation & Management (office visit)


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


D0220 - intraoral - periapical first radiographic image
can be cross coded to:
70300 - Radiologic examination, teeth; single view



D4321 - provisional splinting - extracoronal
D0460 - pulp vitality tests
D3310 - Endodontic therapy anterior tooth (excluding final restoration)

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 use the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Hope this helps!
Guest
#3 Posted : Tuesday, March 9, 2021 9:59:09 AM(UTC)
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Thank you very much for the quick reply and your time and help. It is greatly appreciated.
CS
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