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CPT code for the repositioning of the mandible for the young child.
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Hi Guest!
How is the mandible being repositioned? Surgically, with a removable or fixed appliance, etc?
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by removable appliance, thank you.
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By removable appliance, thsnk you.
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Hi Guest!
Ok great.
If this is a custom made oral sleep appliance (to treat snoring/sleep apnea/sleep disordered breathing), you will use:
0486 - Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment
If this is a prefabricated oral sleep appliance (to treat snoring/sleep apnea/sleep disordered breathing), you will use:
E0485 - Oral device/appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, prefabricated, includes fitting and adjustment
If it is a removable appliance isn't for sleep, there aren't great crosscodes available to represent removable appliances, so they typically end up falling under a "misc", "unspecified" or "by report" type code, such as:
21299 - Unlisted craniofacial and maxillofacial procedure
Hope this helps!
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Rank: Guest
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I have a few more questions regarding 21299, that it's multiple visits after the placement of the removable appliance. Do I need to bill the follow-up adjustment visits separately and is there any code for these additional adjustment/follow-up visits?
Thanks again!
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Rank: Administration
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Hi Guest!
Great question. Yes you will want to bill those follow up visits separately - most medical insurers don't include follow up visits in the code billed for TMJ disorder appliances. (For sleep appliances (E0486) there is 90 days of follow up care typically included, but we just don't see that very often for TMJ disorder appliances!)
You will typically bill out your TMJ disorder appliance follow up under the established patient E&M code set 99211-99215:
99211 – under 10 mins
99212 – 10-19 mins
99213 – 20-29 mins
99214 – 30-39 mins
99215 – 40-54 mins
Hope this helps!
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