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Can you please tell me what medical icd9 code(s) can a dentist use to bill my HMO insurance for a crown with a screw in it to be placed on an implant? I had 2 surgeries to remove 2 radicular cysts on tooth #4 and #5. Unfortunately, they had to remove tooth 5 during the second surgery in order to properly get to the cyst. From the beginning this was and has been a medical condition and my insurance, Anthem Blue Cross HMO, has paid for everything. The only thing I need now is the actual special crown that contains the screw that will be attached to the implant in my mouth. I found a dentist that also take medical insurance for conditions such as mine. I had my consultation with him, his office processed the paperwork to my insurance company for approval and yesterday I was denied. Reason being, this is a dental issue. But, this was not a dental issue to begin with. They could not get to the 2nd cyst without removing the tooth, which was damaged due to the cyst. My question is, what code does the dentist need to use in order for my medical insurance to pay for the tooth/crown? Edited by user Friday, April 7, 2017 10:45:57 AM(UTC)
| Reason: Forgot to mention that cyst damaged the tooth that needed to be removed.
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Hi guest!
The current version of diagnosis codes is actually ICD-10 instead of ICD-9 (that transition took place October 1, 2015), so here are some ICD-10 coding options for you below based on what you described:
K04.8 - Radicular cyst
When you say the tooth was damaged from the cyst, what type of damage? (i can look up coding options for you based on what type of damage the cyst caused). For example, if the tooth was cracked, the ICD-10 code for that is: K03.81 - Cracked tooth.
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