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Hi,
I have a patient who broke his tooth due to a full metal baby sipper cup that had fallen onto his face and broke his front tooth. It was broken at the bone level and he was seen at the ER and sent to us for ext, implant placement and temp tooth.
We did that since it was one of his front tooth on the weekend without preauthorization from the insurance company. They said that they usually require preauthorization (we did not know that since we are new to medical billing)
Please let me know what Diagnosis codes I should be using to bill this and which CD 10 codes should be used as well for
Surigcal root removal #10
Dental implant placement
temporary tooth for #10
and then the final abutment and crown for implant #10.
Your help for this will be greatly appreciated.
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Guest!
Great questions. Based on what you described below, here are some ICD-10 coding options for you:
K03.81 - Cracked tooth
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
W20.8XXA - Other cause of strike by thrown, projected or falling object, initial encounter
As for the procedures you listed:
Dental implant placement:
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)
Surigcal root removal #10
temporary tooth for #10
and then the final abutment and crown for implant #10
As for the three services above, they do not have direct crosscodes 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
Hope this helps!
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