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Joined: 9/8/2012(UTC) Posts: 17,285
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Hi,
We have a patient who had 8 & 9 extracted after a fall (W10.9XXA) should I used diagnosis pointer S02.5XXA(b) for all restorative services related to this injury or switch to K08.419 as the pointer for restoring the implants? FYI The periodontist who extracted the teeth and placed the implants used S02.5XXA for all of his services including subsequent encounters and the claims were (eventually) successful.
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Rank: Administration
Joined: 11/21/2012(UTC) Posts: 1,611
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Hi Lauren Hunte!
Great question. Based on what you're describing, I would consider using the partial loss of teeth due to trauma code for your services since they are now missing, as S02.5XXA/B are for Fracture of tooth (traumatic), initial/subsequent encounter for closed fracture.
However, instead of using K08.419 (Partial loss of teeth due to trauma, unspecified class) You may consider a more specific code: K08.411 - Partial loss of teeth due to trauma, class I K08.412 - Partial loss of teeth due to trauma, class II K08.413 - Partial loss of teeth due to trauma, class III K08.414 - Partial loss of teeth due to trauma, class IV
And instead of: W10.9XXA - Fall (on) (from) unspecified stairs and steps, initial encounter
You may consider either: W10.9XXD - Fall (on) (from) unspecified stairs and steps, subsequent encounter or W10.9XXS - Fall (on) (from) unspecified stairs and steps, sequela
Hope this helps!
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