|
Hi Joel!
You will need both ICD-10 (diagnosis) codes and CPT (procedure) codes when billing to medical insurance. I have listed the CPT code conversions for the dental codes you listed below, however in order to offer you ICD coding options, I'll need some information about your wife's condition in order to do so (in other words, why were these services done? i.e. due to an accident, atrophy of the jaw bones, etc).
D0150 - comprehensive oral evaluation - new or established patient and D0160 - detailed and extensive oral evaluation - problem focused, by report can be crosscoded to a new or established patient evaluation & management (E&M) codes - 99202-99205 (new patients), or 99211-99215 (established patient):
New patients: 99202 – 15-29 mins 99203 – 30-44 mins 99204 – 45-59 mins 99205 – 60-74 mins
Established patients: 99212 – 10-19 mins 99213 – 20-29 mins 99214 – 30-39 mins 99215 – 40-54 mins
D0210 - intraoral - complete series of radiographic images can be crosscoded to: 70320 - Radiologic examination, teeth; complete, full mouth
D9243 - Intravenous moderate (conscious) sedation/analgesia – each 15 minute increment and D9239 - Intravenous moderate (conscious) sedation/anesthesia – first 15 minutes can be crosscoded to:
99152 Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older
and
99153 Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; each additional 15 minutes intraservice time (list separately in addition to code for primary service)
D9215 - Local anesthesia in conjunction with operative or surgical procedures can be crosscoded to: 00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified 00190 - Anesthesia for procedures on facial bones or skull; not otherwise specified
D6010 - surgical placement of implant body: endosteal implant can be cross coded to: 21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial 21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete
D7912 - complicated suture - greater than 5 cm can be crosscoded to: 40831 - repair mouth laceration, complex or 2.5 or more
D0330 - panoramic radiographic image Can be cross coded to: 70355 - Orthopantogram (eg, panoramic x-ray)
D0367 - Cone beam CT capture with interpretation with field of view of both jaws, with or without cranium
There is actually not currently a specific CPT code for CBCT……the closest CPT code is: “70486 - Computed tomography, maxillofacial area; without contrast material”. Many offices have been using this for some time for CBCT, and some insurers require this code to be used for CBCT (i.e. UHC). However, some medical insurers are auditing that code when used for CBCT because the description does not specify “cone beam”. So, “76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional)” is an option to use (keep in mind you'll need to provide a narrative description for unlisted codes).
D0350 - 2D oral/facial photographic image obtained intra-orally or extra-orally D0470 - diagnostic casts D6056 - prefabricated abutment - includes modification and placement D6119 - implant/abutment supported interim fixed denture for edentulous arch – maxillary D6190 - radiographic/surgical implant index, by report D7140 - Extraction, erupted tooth or exposed root (elevation and/or forceps removal) D9951 - occlusal adjustment - limited
The codes listed above do not have a direct crosscode we are aware of - 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!
|
|
I need your assistance for a medically necessary dental Implant and bone grafting. Please provide to me the medical billing codes for the following dental billing codes: D0150, D0210, D0350, D0367, D0160, D0470, D9243,D9215, D6010, D6056, D9243, D6119, D6190, D7912, D0330, D9239, D7140 & D9951.
My wife had to have these procedures done last Decemberdue to a medical necessity. The Oral Surgeon provided us with a letter stating everything she did should be submitted to my medical insurance company.
I tried sending the invoice with the above codes to my medical insurance (Aetna). They sent it back, stating that they must have the medical billing codes in order to process anything for payment and her Oral Surgron claims to have no clue how to convert the dental billing codes to medical billing codes.
Please help! We are out $35,000.00 right now that we had to pull from our already meager retirement account.
Sincere Regards and a Harty THANK YOU!,
Joel A. Thomason
|
|
Hi Guest!
D6010 - surgical placement of implant body: endosteal implant can be crosscoded to: 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)
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
As far as the ICD-10 diagnosis code(s) for these service, that will depend on the patient's condition and why the services were done.
For example, if the bone grafts and implants were done due to atrophy, you may end up using one of the following:
K08.21 - Minimal atrophy of the mandible K08.22 - Moderate atrophy of the mandible K08.23 - Severe atrophy of the mandible K08.24 - Minimal atrophy of maxilla K08.25 - Moderate atrophy of the maxilla K08.26 - Severe atrophy of the maxilla
If it is being done for another reason (i.e. accident, loss of teeth, etc), let me know and I can offer you some coding options.
Hope this helps!
|
|
Could you please help me with the two codes D6010 and D7953. What is the ICD 10 codes for these two codes? Thank you so much
|