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Yes! Thank you so much! I was wondering if I should use the sequela, I am glad I asked. You have been very helpful!
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Hi tcfd1vldg!
No problem!
Starting off the with diagnosis code(s). The one you listed:
W50.0XXA - Accidental hit or strike by another person, initial encounter
Since this is a case stemming from a childhood trauma, you may want to consider:
W50.0XXS - Accidental hit or strike by another person, sequela
You may also want to considering coding the trauma to the mouth/teeth. For example, here are come oral trauma related ICD-10 codes:
K03.81 - Cracked tooth
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
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
Then, for the crowding:
M26.31 - Crowding of fully erupted teeth
So, all the diagnosis codes you select will be entered in box 21 of the CMS1500 claim form.
As for the procedures, those codes (CPT) will be entered in box 24.
Bone grafting:
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
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)
Crown:
Crowns do not have a direct crosscode we are aware of, 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 try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
Hope this helps!
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We have a patient in our office who had trauma to the mouth when he was a child. I am confused as to how to code this. I am using W50.0XXA- accidental hit by another person, then the codes for bone grafting, implant placement and crown over implant placement. There is crowding of the other teeth, which we are doing crowns on. Do I submit ICD codes for each tooth that a crown is placed on? Where would the W code I am using go. I am just so confused with this one!
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