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I was hoping for some guidance on cross-coding/ diagnosis codes for D8090 to re-align bite and stabilize alveolar ridge buccal plate fracture (maxilla) after traumatic injury (caused by temporary loss of consciousness/ fainting, facial impact to concrete floor).
So far I've got Dx code S02.42 to indicate the alveolar fracture... are there any other codes, modifiers, etc. that would be indicated or helpful in the successful processing of this claim (e.g. T14.8?)
Also, would I need to apply any separate diagnosis codes/ modifiers for diagnostic records/ radiography converted codes as well (D0340, D0330, D0470, D0350) or just the narrative describing how I am using the 99070 code in their place?
Thank you for your help, I've already learned a lot just reading previous posts/ questions!
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Hi Guest!
No problem :) Starting off with your diagnosis code(s):
S02.42 does stand for: Fracture of alveolus of maxilla. However, you will want to add some characters on to it to be more specific as S02.42 alone is not billable. Here are your more specific options below:
S02.42XA - Fracture of alveolus of maxilla, initial encounter for closed fracture
S02.42XB - Fracture of alveolus of maxilla, initial encounter for open fracture
S02.42XD - Fracture of alveolus of maxilla, subsequent encounter for fracture with routine healing
S02.42XG - Fracture of alveolus of maxilla, subsequent encounter for fracture with delayed healing
S02.42XK - Fracture of alveolus of maxilla, subsequent encounter for fracture with nonunion
S02.42XS - Fracture of alveolus of maxilla, sequela
T14.8 stands for: Other injury of unspecified body region
Same on this one, if you are going to use it you will want to use a more specific one:
T14.8XXA - Other injury of unspecified body region, initial encounter
T14.8XXD - Other injury of unspecified body region, subsequent encounter
T14.8XXS - Other injury of unspecified body region, sequela
I would also recommend using a code to describe how the injury occurred. Based on what you described below, this may be appropriate:
R55 - Syncope and collapse
You would not necessarily need separate diagnostic codes for any radiographs, likely they will be the same (as the fracture & fall are the reasons all services are being done).
As for the CPT crosscodes for the "D" codes you listed:
D0340 - 2D cephalometric radiographic image – acquisition, measurement and analysis
can be crosscoded to:
70350 - Cephalogram, orthodontic
or
70250 - x-ray lateral skull
D0330 - panoramic radiographic image
Can be cross coded to:
70355 - Orthopantogram (eg, panoramic x-ray)
D0470 - diagnostic casts
can be crosscoded to:
99070 - special supplies & materials
or
A4580 - cast supplies (e.g. plaster)
D0350 - 2D oral/facial photographic image obtained intra-orally or extra-orally
can be crosscoded to:
99070 - special supplies & materials
And yes, a narrative report describing what 99070 is being used for is highly recommended.
Hope this helps!
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