Rank: Member
Joined: 10/16/2013(UTC) Posts: 20
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We performed a Frenulectomy on a patient which was causing gingival recession. I submitted to her medical insurance as procedure code 40819 and diagnosis code K06.0. However, the claim was returned as "the claim is being disallowed because the diagnosis code requires a fourth or fifth digit to provide appropriate specificity". Wondering what other code I should be using for gingival recession?
Thanks!
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Rank: Administration
Joined: 11/21/2012(UTC) Posts: 1,611
Thanks: 39 times Was thanked: 51 time(s) in 51 post(s)
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Hi jbublik!
Here they are below!
K06.010 - Localized gingival recession, unspecified K06.011 - Localized gingival recession, minimal K06.012 - Localized gingival recession, moderate K06.013 - Localized gingival recession, severe K06.020 - Generalized gingival recession, unspecified K06.021 - Generalized gingival recession, minimal K06.022 - Generalized gingival recession, moderate K06.023 - Generalized gingival recession, severe
Also, diagnosis coding options for frenum issues: Q38.1 - Ankyloglossia Q38.0 - Congenital malformations of lips, not elsewhere classified
Hope this helps!
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