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#1 Posted : Tuesday, May 11, 2021 4:44:27 PM(UTC)

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Hi - Very frustrated trying to translate 2 foreign languages (dental vs. medical coding) so I can be reimbursed by my medical plan for a minor oral surgical procedure. Very glad to find your service!

Need Procedure codes for the following:


After review of previous posts I was able to find the medical code for my anesthesia. Thanks for that!

Need ICD format diagnostic code for: mass/lesion on left hard palate.
Apparently dental coding doesn't require a diagnostic code, as their system considers the procedural codes to be sufficient.

Thanks very much
#2 Posted : Thursday, May 13, 2021 9:57:31 AM(UTC)

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Hi Guest!

D7286 - incisional biopsy of oral tissue-soft

Here are some CPT cross coding options for you:

40490 - Biopsy lip
40808 - Biopsy, vestibule of mouth
41108 - Biopsy of floor of mouth
41110 - Biopsy of tongue, anterior two-thirds
41105 - Biopsy of tongue, posterior one-third

D9612 - therapeutic parenteral drugs, two or more administrations, different medications
can be crosscoded to:
96372 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
96373 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial

D9630 - other drugs and/or medicaments, by report
can be crosscoded to:
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)

D0367 - Cone beam CT capture with interpretation with field of view of both jaws, with or without cranium

There is actually not currently a specific CPT code for CBCT……the closest CPT code is: “70486 - Computed tomography, maxillofacial area; without contrast material”. Many offices have been using this for some time for CBCT, and some insurers require this code to be used for CBCT (i.e. UHC). However, some medical insurers are auditing that code when used for CBCT because the description does not specify “cone beam”.

So, “76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional)” is an option to use (keep in mind you'll need to provide a narrative description for unlisted codes) We also see practices billing out for "76102 - Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urography; bilateral"

As for the ICD-10 diagnostic code for mass/lesion on left hard palate, here are some coding options (it would be best to confirm with your doctor which best apply):

K12.2 - Cellulitis and abscess of mouth
K09.0 - Developmental odontogenic cysts
K09.1 - Developmental (nonodontogenic) cysts of oral region
K09.8 - Other cysts of oral region, not elsewhere classified
C05.0 - Malignant neoplasm of hard palate
D00.05 - Carcinoma in situ of hard palate
D10.39 - Benign neoplasm of other parts of mouth
D37.09 - Neoplasm of uncertain behavior of other specified sites of the oral cavity

Hope this helps!
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