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Guest
#1 Posted : Friday, December 23, 2016 3:05:37 AM(UTC)
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Guest

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Thanks for your help!
Our kids have cleft lip and palates, so need implants and bone grafting to do so. Our daughter's was done a few months ago, and the oral surgeon's office and prosthetic dentist don't file medical! I need these codes transposed so I can file them and get my $4300 back from insurance!
7210 Surg Extraction
9223 General Anesthesia (x 4; are there diff #'s for amt of time?)
6010 Surgical implants
7950 Graft - Upper/Lower
9630 Drugs/Medicine

Thank you!
courtneydsnow
#2 Posted : Monday, December 26, 2016 11:56:08 AM(UTC)
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courtneydsnow

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Hi guest!

First off (in case you don't already have them), the ICD-10 diagnosis coding options for cleft lip/palate are below:
Q37.0 - Cleft hard palate with bilateral cleft lip
Q37.1 - Cleft hard palate with unilateral cleft lip
Q37.2 - Cleft soft palate with bilateral cleft lip
Q37.3 - Cleft soft palate with unilateral cleft lip
Q37.4 - Cleft hard and soft palate with bilateral cleft lip
Q37.5 - Cleft hard and soft palate with unilateral cleft lip
Q37.8 - Unspecified cleft palate with bilateral cleft lip
Q37.9 - Unspecified cleft palate with unilateral cleft lip



D9630 - other drugs and/or medicaments, by report
can be crosscoded to:
99070 - Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)


D6010 - surgical placement of implant body: endosteal implant
can be crosscoded to:
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)


D7950 - osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla - autogenous or nonautogenous, by report
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



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


D9223 - deep sedation/general anesthesia — each 15-minute increment
can be crosscoded to:
00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
00172 - Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
00174 - Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor
00176 - Anesthesia for intraoral procedures, including biopsy; radical surgery
01999 - Unlisted anesthesia procedure(s)

• 99143 - Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; younger than 5 years of age, first 30 minutes intra-service time

• 99144 - Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; age 5 years or older, first 30 minutes intra-service time

• 99145 - Moderate sedation services (other than those services described by codes 00100-01999) provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; each additional 15 minutes intra-service time (List separately in addition to code for primary service)

• 99148 - Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician or other qualified health care professional other than the health care professional performing the diagnostic or therapeutic service that the sedation supports; younger than 5 years of age, first 30 minutes intra-service time


• 99149 - Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician or other qualified health care professional other than the health care professional performing the diagnostic or therapeutic service that the sedation supports; age 5 years or older, first 30 minutes intra-service time

• 99150 - Moderate sedation services (other than those services described by codes 00100-01999), provided by a physician or other qualified health care professional other than the health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intra-service time (List separately in addition to code for primary service)

Hope this helps, have a great day!
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