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Can my insurance be billed for d7953 and d6104 for the same site, at the same visit? Implants placed same day as well.
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Hi Guest!
D7953 - bone replacement graft for ridge preservation - per site
Can be cross coded to:
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
D4266 - guided tissue regeneration - resorbable barrier, per site
can be cross coded to:
41870 - Periodontal mucosal grafting
or
41899 - Unlisted procedure, dentoalveolar structures
**include narrative report to describe the procedure
Hope this helps!
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hi what is medical procedure for D7953 and D4266. my dentist said if converted medical insurance might pay for it
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Hi Guest!
Sorry to clarify - are you saying you're looking for the medical codes to use for extractions, bone grafts, and implants?
If so, here are some coding options below:
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
Implants:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3or less)
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)
Extractions:
Extractions do not have direct crosscodes 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 use the CPT codes below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
Hope this helps!
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Originally Posted by: courtneydsnow  Hi Guest!
Great question - yes the insurer may very well be looking for the crosscode. Quick question - was it your medical insurer or your dental insurer that you were looking at? I have that same question my insurance is set up to get the approval from my medical insurance. I have the same question as this young lady as this was my coding from the dental as well. QuoteMulti-QuoteGuest Posted : 2 years ago I have a treatment plan from my periodontist to pull 4 teeth and apply bone grafts to three of them; and 6 months from now will return for dental implants. For the three teeth requiring a bone graft, they are using Codes D7210 (Extraction-surgical/erupt tooth), D7953 (Bone Replacement w/ext) and D4266 (Guided tissue regen-resorb-per). In calling my insurance carrier, and searching their site by code, it appears that the Code D7953 no longer exists. Can you tell me what procedure code should be used for Bone Replacement w/ext - are they cross-coding or coding incorrectly for what I described? Thank you.
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Hi Guest!
Yes, Medicare certainly does have a 90 day global period associated with HCPCS code E0486 (for custom made oral appliances for Obstructive Sleep Apnea), however I don't believe the global period is necessarily the same for surgical procedures (many insurers will have a 10 to 14 day global period associated with surgical procedures).
As for coverage availability and criteria for Medicare for sinus lifts - this will likely vary depending on your Medicare Part B jurisdiction. I would recommend visiting your Medicare Part B MAC's website and searching the LCD's for CPT 21210 to see if there is additional coverage information available.
Hope this helps!
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i understand that medicare has three months global period for billing. what if I do sinus lift on both sides? can I? If yes, will i be reinbursed for both bone grafts?
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Hi Guest!
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
Hope this helps!
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What is the medical code for D7951 if I had to have an extraction?
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wow that's great it is to build bone for an implant in 6 months!!
thank you so much!!!
Lee
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