Hi Guest!

No problem.

For the trauma, you're likely looking at:

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


There will also be a code to describe how to accident happened. Depending on the details of how it happened, here are some coding options:

- W01.0XXA - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, initial encounter
- W01.198A - Fall on same level from slipping, tripping and stumbling with subsequent striking against other object, initial encounter
- W03.XXXA - Other fall on same level due to collision with another person, initial encounter
- W18.01XA - Striking against sports equipment with subsequent fall, initial encounter


And a few to identify where it happened:

Y92.39 - Other specified sports and athletic area as the place of occurrence of the external cause
Y92.310 - Basketball court as the place of occurrence of the external cause
Y92.311 - Squash court as the place of occurrence of the external cause
Y92.312 - Tennis court as the place of occurrence of the external cause
Y92.318 - Other athletic court as the place of occurrence of the external cause
Y92.320 - Baseball field as the place of occurrence of the external cause
Y92.321 - Football field as the place of occurrence of the external cause
Y92.322 - Soccer field as the place of occurrence of the external cause
Y92.328 - Other athletic field as the place of occurrence of the external cause


Hope this helps!

Hi Guest!

Yes 21140 is not a valid CPT code, that was a typo on my part! Thank you for pointing that out so i can correct that post!

21440 stands for:
Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)

Hi Gaylen!


D7951 - sinus augmentation with bone or bone substitutes via a lateral open approach
can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
*use -52 modifier for reduced services when bone is not obtained from the patient


D4266 - guided tissue regeneration - resorbable barrier, per site

There is not a direct crosscode available for this service, so if the medical insurer will not accept the "D" code on the medical claim (many will these days when they are medically necessary procedures), or you can use the code below and include narrative report to describe the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Now, as for the diagnostic code(s) - that will depend on why these services performed, or basically, what issues/condition(s) are being treated?

For example, if there is atrophy of the maxilla (upper jaw):

K08.24 - Minimal atrophy of maxilla
K08.25 - Moderate atrophy of the maxilla
K08.26 - Severe atrophy of the maxilla


Hope this helps!

Hi Glenda!


D2740 - crown - porcelain/ceramic
D2950 - core buildup, including any pins when required
D0350 - 2D oral/facial photographic image obtained intra-orally or extra-orally
D6750 - retainer crown - porcelain fused to high noble metal
D6245 - pontic - porcelain/ceramic
D9944 - occlusal guard – hard appliance, full arch


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

Hope this helps!

Hi Guest!

You are correct on the crosscodes you already listed, and here are the remaining:

D0270 - bitewing - single radiographic image
can be cross coded to:
70300 - Radiologic examination, teeth; single view


D9230 - inhalation of nitrous oxide/analgesia, anxiolysis

D9230 does not have a crosscode, so since it sounds like your medical insurer is not accepting the "D" code on the medical claim (many medical insurers will process the "D" code on the medical claim when they are medically necessary procedures these days), you may consider:
01999 - Unlisted anesthesia procedure(s)
And heads up, some medical insurers will consider this included in the office visit (evaluation & management code) and will not pay it separately.


D2954 - prefabricated post and core in addition to crown

There are not direct crosscodes we are aware of for the procedures listed above, so you can either use 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.



And since this is an accident case, you will want to provide ICD-10 diagnosis codes that describe the trauma to teeth, pain if present, and how the accident happened:

For the fractured teeth:
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture

If there was acute pain:
G89.11 - Acute pain due to trauma

And as for the code to describe how the accident happened, if you'd like to reply with some details about the accident i'm happy to offer you some coding options. There are codes for vehicle accidents, sports accidents, fights, falls, etc etc etc.


Hope this helps!

Hi Guest!

Absolutely:

For the bone grafts:

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


For the implants:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial
21249 - 21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)


Dentures do not have a direct crosscode - so you can either bill the "D" code (dental 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!

Hi Guest!

D8080- Comprehensive orthodontic treatment of the adolescent dentition

Ortho does not have a direct crosscode we are aware of, many insurers these days will process "D" codes when they are medically necessary services - but since your insurer will not, or you can use the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures

Or, we have seen a few insurers accept this code for ortho:
21110 - Application of interdental fixation device for conditions other than fracture or dislocation, includes removal


Hope this helps!

Hi Guest!


D7953 - bone replacement graft for ridge preservation - per site
and
D7951 - sinus augmentation with bone or bone substitutes via a lateral open approach
for an upper tooth, can be cross coded to:
21210 - Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)
**use modifier -52 for reduced services when bone is not obtained from patient


D9222 – deep sedation/general anesthesia – first 15 minutes
and
D9223 – deep sedation/general anesthesia – each additional 15 minutes
can be crosscoded to:

00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
00172 - Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
00174 - Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor
00176 - Anesthesia for intraoral procedures, including biopsy; radical surgery


D6010 - surgical placement of implant body: endosteal implant
can be cross coded to:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete


D7140 - Extraction, erupted tooth or exposed root (elevation and/or forceps removal)
D7956 - guided tissue regeneration, edentulous area – resorbable barrier, per site
D6190 - radiographic/surgical implant index, by report


The codes listed above do not have a direct crosscode we are aware of - 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!