Hi Eastland Dental Center!

While dental coding is not our forte like medical coding is, here is some medical coding information for the case you described below :)


ICD-10 diagnosis coding options:

S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture


W22.8XXA - Striking against or struck by other objects, initial encounter
W01.10XA - Fall on same level from slipping, tripping and stumbling with subsequent striking against unspecified object, initial encounter
W18.09XA - Striking against other object with subsequent fall, initial encounter


CPT procedure:

There is not a specific CPT code for bonding a piece of tooth back in place, so you will end up using:
41899 - unlisted procedure, dentoalveolar structures

and be sure to include a narrative report describing the accident & procedure :)


Hope this helps!

Hi Guest!

If the broken incisor was due to accidental injury/trauma and you're billing it to medical insurance, you would actually typically end up using CPT code 41899 (which stands for Unlisted procedure, dentoalveolar structures), because there is not a specific CPT code for bonding or filings.

You may also consider using the ZZ and/or JP qualifiers to provide additional information on the line item.

The JP qualifier to indicates the tooth numbers. So for example if it was tooth number 8, it would read:
JP8

The ZZ qualifier indicates you will be providing a short description, like this:
ZZbonding for fractured tooth

An example of how to use the ZZ and JP qualifiers on the medical claim can be found int he NUCC's claim form manual on page 47 & 48, here is a link to it:
https://nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2021_07-v9.pdf

You would also use diagnosis codes, for example:

For the broken/fractured tooth:
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 pain:
G89.11 - Acute pain due to trauma

And to describe the accident. For example, struck by a softball:
W21.07XA - Struck by softball, initial encounter

(there's tons of codes to describe different accidents, if you can supply me with details about how an accident happened, I'm happy to offer you some coding options).

Hope this helps!

Hi Guest!

Great question. You can either use the "D" codes you listed on the medical claim (many medical insurers these days accept the "D" codes on the medical claim when they are medically necessary services).
Or, if you choose to use 41899, you will want to list it separately for each of those services so you can indicate the appropriate fee for each, and then you can use the "ZZ" qualifier in the supplemental information area on the line item (the red shaded lines in field 24 that are typically left blank) and provide a short description of the service, for example:
ZZ reattachment of tooth
ZZ pulp test
ZZ partial pulpotomy
ZZ intraoral photos

These two codes are great for a traumatic tooth fracture with acute pain:
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
G89.11 - Acute pain due to trauma

However, instead of W21.07XA (Struck by softball, initial encounter), there is a different code for struck by baseball!
W21.03XA - Struck by baseball, initial encounter

Hope this helps!