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legacyranch
#1 Posted : Tuesday, September 4, 2018 1:59:11 PM(UTC)
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legacyranch

Rank: New Member

Joined: 4/26/2016(UTC)
Posts: 1

What is the proper way to bill fluoride trays for a patient undergoing head and neck radiation for tonsillar cancer?

Teh Oncologist wants all existing decay taken care of right away and then on to fluoride trays

Also he has mucositis in the first week starting chemo. We now have to deal with that as well and are introducing medicatiosn in office to help.

ANy advise on this woudl be appreciated
courtneydsnow
#2 Posted : Wednesday, September 5, 2018 12:12:29 PM(UTC)
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courtneydsnow

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Joined: 11/21/2012(UTC)
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Hi legacyranch!

Great question. There is actually not a specific medical code for fluoride trays. You can either use the “D” code on the medical claim, or use a non-specific code and describe it in the narrative report such as:

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)

As for the mucositis treatment:

Diagnosis coding options:

K12.0 - Recurrent oral aphthae
K12.1 - Other forms of stomatitis
K12.31 - Oral mucositis (ulcerative) due to antineoplastic therapy
K12.32 - Oral mucositis (ulcerative) due to other drugs
K12.33 - Oral mucositis (ulcerative) due to radiation
K12.39 - Other oral mucositis (ulcerative)
T45.1X5 - Adverse effect, if applicable, to identify antineoplastic and immunosuppressive drugs

CPT/HCPCS coding

S8948 - Application of a modality (requiring constant provider attendance) to one or more areas; low-level laser; each 15 minutes.

41820 - Destruction of lesion, vestibule of mouth by physical methods

41850 - Destruction of lesion; dentoalveolar structures

42160 - Destruction of lesion, palate or uvula

Sample medical coverage policy from BCBS Florida titled "Infrared Energy Therapy and Low Level Laser Therapy which states “Low-level laser therapy meets the definition of medical necessity for prevention of oral mucositis in members undergoing cancer treatment associated with increased risk of oral mucositis, including chemotherapy and/or radiotherapy, and/or hematopoietic stem cell transplantation.”

http://mcgs.bcbsfl.com/?doc=Infrared%20Energy%20Therapy%20and%20Low%20Level%20Laser%20Therapy


Hope this helps, have a great day!
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