Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 16,815
Was thanked: 16 time(s) in 15 post(s)
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So grateful I have found this site. My periodontist's office is horrible. They do no know how to cross code therefore they offer nothing in terms of help. The procedures I had may indeed be covered by my medical coverage, but I have no one to help me.
I had a tooth pulled and a bone graft in December 2020. Codes are: D7210 and D7953.
Just had implant and major sinus lift on 8/4/21. Codes are D7951 and D6010.
Any help you can offer would be great. I feel like I have to take a course in this to get anywhere. I am so frustrated and this entire procedure cost nearly $7,000 so anything that medical will pay will help me.
Courtney Snow, I so hope you are still responding here.
Thank you!
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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 Guest!
Yes, I am here! :)
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
D7951 - sinus augmentation with bone or bone substitutes via a lateral open approach
can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
*use -52 modifier for reduced services when bone is not obtained from the patient
D6010 - surgical placement of implant body: endosteal implant
can be cross coded to:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3 or less)
D7210 - Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated
Extractions actually do not have direct crosscode - 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 code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
Hope this helps!
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 1 user thanked courtneydsnow for this useful post.
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Rank: New Member
Joined: 8/10/2021(UTC)
Posts: 5
Thanks: 3 times
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I thanked you in the other answer you provided to me, but I wanted to thank you here as well!
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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 m1z!
Aw thanks, it's my pleasure :)
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