Hello, we attended the course last saturday at VA. We're still trying to figure things out. We need to submit med claim for CT Scan (D0364) and Surgical guide (D6190). Please help! What diagnosis code we need to use?

Thank you!

Susan

Hi Courtney,

Thank you so much for helping us on this matter! We performed Extraction, graft and added tissue to the area due to fractured and abscessed mandible tooth #19. So we need to take CT Scan and surgical guide for implant placement.

Again, thank you!

Susan

Great!Thank you Courtney.

How about the D9940, how do you code them for bruxism, muscle spasm, joint pain and excessive wear of teeth due to grinding?

What is the CPT/HCPCs code can we use for D9940?

Hi Susan!

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

D4267 - guided tissue regeneration - nonresorbable barrier, per site (includes membrane removal)
can be cross coded to:
41870 - Periodontal mucosal grafting

D7210 - surgical removal of erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated

The code listed above does not have a direct crosscode we are aware of, so you can either bill the "D" code on the medical claim (many insurers these days will process "D" codes when they are medically necessary services), or you can try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


And as for the ICD-10 code for vertical fracture due to trauma - where was the fracture?

Hi Guest!

As for the CPT code for surgical guide, there is not a direct crosscode we are aware of, so you can either bill the "D" code on the medical claim (many insurers these days will process "D" codes when they are medically necessary services), or you can use the CPT codes below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


For for the Cone Beam CT:

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, 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) We also see practices billing out for "76102 - Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urography; bilateral"
or, there are some medical insurers that will process the “D” codes for procedures when there is not a specific CPT code available.

For example, here are the “D” codes from HealthPartner’s medical policy for “Cone-beam computed tomography (CT) scan for medically-related dental services”
D0363 - Cone-Beam 3D multi image reconstruction
D0364 - Cone beam CT capture and interpretation with limited field of view - less than one whole jaw
D0365 - Cone beam CT capture and interpretation with field of view of one full dental arc - mandible
D0366 - Cone beam CT capture and interpretation with field of view of one full dental arch - maxilla, with or without cranium
D0367 - Cone beam CT capture with interpretation with field of view of both jaws, with or without cranium
D0368 - Cone beam CT capture and interpretation for TMJ series including two or more exposures
D0380 - Cone beam CT image capture with limited field of view - less than one whole jaw
D0381 - Cone beam CT image capture with field of view of one full dental arch - mandible
D0382 - Cone beam CT image capture with field of view of one full dental arch - maxilla, with or without cranium
D0383 - Cone beam CT image capture with field of view of both jaws, with or without cranium
D0384 - Cone beam CT image capture for TMJ series including two or more exposures

Here is a link to the full policy:
https://www.healthpartners.com/public/coverage-criteria/policy.html?contentid=AENTRY_045861


Hope this helps!

Hi Guest!

No problem, the e-mail is on its way to you