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#1 Posted : Monday, September 13, 2021 10:36:51 AM(UTC)

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My 16-year-old daughter is missing two teeth congenitally. She also had both of her canine teeth impacted which destroyed both roots of her two front teeth which had to be pulled. One of her impacted canines became ankylosed, so it also needs to be removed. She will need a total of 5 implants. Can someone please help me with the medical codes? We have Highmark Blue Cross medical, and United Concordia dental.

Thank you!
#2 Posted : Tuesday, September 14, 2021 11:47:16 AM(UTC)

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Hi Jill!

Based on what you described, here are some ICD-10 (diagnosis coding) options:

K00.0 - Anodontia
K01.1 - Impacted teeth
K03.5 - Ankylosis of teeth

And as for the procedure codes for extractions & implants:

21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3 or less)
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)

Extractions actually do not have 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

Hope this helps!
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