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Guest
#1 Posted : Thursday, October 20, 2016 3:39:56 PM(UTC)
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Guest

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I have a patient who was hit in the mouth and ended out needing the tooth to be reimplanted {D7270}, had a root canal {D3310} and internal bleaching {D9974}. The medical insurance is asking that the dental codes be converted to medical codes and also want a diagnosis code.

Any help with this is appreciated, thank you!
mbrzezinski
#2 Posted : Thursday, October 20, 2016 4:42:36 PM(UTC)
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mbrzezinski

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Hi Guest!

D3310 - Endodontic therapy anterior tooth (excluding final restoration)
D9974 - Internal bleaching, per tooth
D7274 - Tooth implantation and/or stabilization of accidentally evulsed or displaced tooth

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

If you let me know what the patient was struck by in the mouth I can assist with a specific diagnosis code.

Hope this helps!
Guest
#3 Posted : Thursday, October 20, 2016 5:48:39 PM(UTC)
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Guest

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Hi,

Thank you for getting back so quickly. This patient in particular was jumping on a trampoline and hit his mouth with his own knee.
We also billed out an after hours procedure D9440.
mbrzezinski
#4 Posted : Monday, October 24, 2016 9:37:23 AM(UTC)
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mbrzezinski

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Hi Guest!
For this pt. I would start with the following:
First, one of the following partial loss of teeth due to trauma codes:
• 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

Then, these two below as well:
W22.8XXA - Striking against or struck by other objects, initial encounter
Y93.44 - Activity, trampolining

D9440- office visit - after regularly scheduled hours
Can be cross coded to:
99050 - Emergency care after hours
**Use in addition to the eval & mgmt. code

Hope this helps!
Guest
#5 Posted : Wednesday, October 4, 2017 5:40:05 PM(UTC)
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Guest

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Hi,
My 10 year old son took a pitch to the face while at bat in a Little League game.
His two front teeth are intact and he needed subsequent root canals. They tried
Pulpal regeneration before performing the root canals to see if the blood supply
Would regenerate. This did not work....as they continued to do he root canals a month later.

Long story short and nearly $2200.00 later, our dental insurance is not covering these charges.
I've spoken with several (medical)billers that have told me that because his root canals were
due to an injury (not lack of care) and because it is involving tissue (his roots of his teeth) that my medical
Insurance should cover this. Not to mention, my medical
Insurance has the paper trail of ER Visit, stitches, x-ray, etc.

The problem I'm having is that my medical
Insurance wants CPT and HCPCS codes. The Endodontist office provides CDT codes. How do I translate one into the other?
Here are the codes from the endodontist office:

CDT 3355 -Pulpal regeneration- initial visit
CDT 3310 - anterior root canal
CDT 39999 - mineral trioxide aggregate Mat

These are all x2 (both front teeth involved.

Thank you for ANY help you can provide.

Krista
courtneydsnow
#6 Posted : Thursday, October 5, 2017 8:02:04 AM(UTC)
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courtneydsnow

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Hi Guest!

D3355 - Pulpal regeneration - initial visit
D3310 - endodontic therapy anterior tooth (excluding final restoration)
D3999 - unspecified endodontic procedure, by report


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, but since your insurer is not taking them, you can try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Hope this helps!
Guest
#7 Posted : Friday, March 26, 2021 5:42:30 PM(UTC)
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Guest

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Hello.

We have a patient that was in a car accident which created severe Bruxism conditions. Due to the last he fracture the 14 first top right premolar.

what are the codes for:
initial visit and evaluation due to car accident of an existing patient.

Extraction of number 14 due to fracture related to the car accident and filling of the alveolar bed?

What is the code for an odontogram/xrays related to the visits due to a car accident?

Code for creation and installation of a muscle control plate for bruxism related to the same accident?

Code for control of the muscle control plate?

Code for customer tele conferences with the Dentist, follow up treatment?

Thank you for all your help!

courtneydsnow
#8 Posted : Monday, March 29, 2021 9:52:01 AM(UTC)
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courtneydsnow

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Hi Guest!

Let's start with the CPT (procedure) coding options:

For the initial evaluation:

Established patient Evaluation & Management (E&M) codes:
99212 – 10-19 mins
99213 – 20-29 mins
99214 – 30-39 mins
99215 – 40-54 mins


Extraction & bone grafts:

Extractions actually not have a direct crosscode, 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

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


Pano X-ray:
70355 - Orthopantogram (eg, panoramic x-ray)


As for the muscle control plate you mentioned - could you provide a bit more detail on this service? It is a removable or fixed intra-oral appliance? Or something that is being surgically implanted?


Telehealth visits:
99421 - Online digital evaluation and management service, for an established patient, for up to 7 days cumulative time during the 7 days; 5-10 minutes
99422 - 11—20 minutes
99423 - 21 or more minutes


Now, as for the diagnosis (codes):
F45.8 - Other somatoform disorders (bruxism)

There will also be a code to describe the car accident, but i'll need more details to offer you coding options. Was the patient the driver or passenger? What types of vehicle(s) were involved, or was it a stationary object or animal?

Hope this helps.
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