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We have a patient that needs two implants and a bone graft due to congenitally missing teeth. Do you think I have a chance with Medical insurance to cover any of these procedures?
If so what codes should I use as well as modifiers.
I have yet to send any implants to medical so I am not exactly sure.
Thank you!
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Hi dentalt33th!
The ICD-10 diagnosis code for congenitally missing teeth is:
K00.0 - Anodontia
ative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
As for the bone graft:
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 for the 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)
As for chance of coverage, it really depends on whether the services are more cosmetic in nature, or if they would be considered medically necessary because the absence of those teeth is impeding the patient's ability to function normally or may cause more severe consequences in the future.
Hope this helps!
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Good morning: Does anyone know the ICD 10 for dental bone loss? Thanks Edited by user Thursday, August 31, 2017 11:04:43 AM(UTC)
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Hi j0hanna21!
Do you mean bone loss of the mandible and/or maxilla? If so, below are some coding options for you:
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 you are talking about bone loss from another area, let me know.
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