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Guest
#1 Posted : Wednesday, February 4, 2015 11:45:12 AM(UTC)
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Guest

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I am trying to send a claim to a medical insurance and am having trouble determining what ICD-9 code(s) are appropriate to bill with CPT code 21210. We did a bone graft post extraction and prior to placing an Implant. What ICD-9 code(s)would best describe a bone graft done in preparation for an Implant
courtneydsnow
#2 Posted : Wednesday, February 4, 2015 2:07:06 PM(UTC)
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courtneydsnow

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Hi Guest!

Great Question. The proper ICD code to use will depend on the patient's condition!!

For example, perhaps the patient suffers from Atrophy of the mandible or maxilla -
Atrophy of the Mandible, Minimal - 525.21
Atrophy of the Mandible, Moderate - 525.22
Atrophy of the Mandible, Severe - 525.23
Atrophy of the Maxilla, Minimal - 525.24
Atrophy of the Maxilla, Moderate - 525.25
Atrophy of the Maxilla, Severe - 525.26

Or another example, perhaps the patient cannot properly eat & chew:
Problems with swallowing & Mastication - V41.6

Or perhaps there was a lesion discovered:
528.9 - Other and unspecified diseases of the oral soft tissues

So basically, when choosing diagnosis codes, it is best to lean on your doctor who is going the diagnosing! What condition(s) or symptom(s) are the reason for doing the biopsy in preparation for the implant? Once you know that, you can choose the diagnosis code that described that or those conditions!

If you have the DentalWriter software, the oral surgery/implant visit form gives you a nice set of diagnosis codes that are commonly used in these types situations to choose from in the assessment tab of the exam form, and you can also find very helpful coding sheets and case examples in DentalWruter CrossCode online as well!

Hope this helps, please let us know if you have any further questions!
Guest
#3 Posted : Sunday, February 14, 2016 12:09:47 AM(UTC)
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Bone graph,implant icd 10 and cpt code
courtneydsnow
#4 Posted : Monday, February 15, 2016 9:49:03 AM(UTC)
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courtneydsnow

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Hi guest!

Here are the CPT codes for bone grafts:

21215 - Graft, bone; mandible (includes obtaining graft)
21210 - Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)

The modifier -52 can be used when bone is not obtained from the patient.

Here are the CPT codes for implants:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete

As far as the ICD-10 diagnosis code(s) to use, this will depend on the patient and their condition (basically, why is the bone graft/implant being done?).

For example, if it is due to atrophy, you may use one of the following codes:

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

Hope this helps, have a great day!

Edited by user Monday, February 15, 2016 9:51:02 AM(UTC)  | Reason: Not specified

 1 user thanked courtneydsnow for this useful post.
FIROUZIAN on 5/2/2016(UTC)
Guest
#5 Posted : Wednesday, September 7, 2016 10:06:33 AM(UTC)
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I am trying to find the recent ADA code for maxilla bone grafting . Also, the ADA code for Caldwell Sinus Lift, right and left. Thank You.
Kathylmcgee@ aol.com
courtneydsnow
#6 Posted : Monday, September 12, 2016 6:43:38 AM(UTC)
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courtneydsnow

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Hi Kathy!

Here are the links to an article from dental economics and a coding paper from AAOMS that i think will help you with those ADA codes:

http://www.dentaleconomi...s-and-bone-grafting.html

http://www.aaoms.org/images/uploads/pdfs/oral_implants.pdf
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