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Question Pregnancy perio prophy's - Need CPT/ICD code for perio pro for pregnant woman
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Guest
#1 Posted : Monday, May 15, 2017 4:03:21 PM(UTC)
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Guest

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I have a pregnant patient that received a RX from her OBGYN to have her teeth cleaned every 3 months due to perio during pregnancy. I tried to submit with perio ICD.

What ICD code would help to get payment and would we use the 41820 for the prophy with modifier 50 for bilateral service?
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mbrzezinski
#2 Posted : Tuesday, June 13, 2017 11:01:31 AM(UTC)
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mbrzezinski

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Hi Guest,

Although most insurers consider periodontal therapy "dental" a few medical insurance carriers may reimburse for this service when "medical necessity" is established.

CPT 41820 GINGIVECTOMY, EACH QUADRANT CPT 41820-50 GINGIVECTOMY, EACH QUADRANT

Modifier -50 specifies a bilateral service

Here are the Perio ICD 10 codes
• K05.211 Aggressive periodontitis, localized, slight
• K05.212 Aggressive periodontitis, localized, moderate
• K05.213 Aggressive periodontitis, localized, severe
• K05.219 Aggressive periodontitis, localized, unspecified severity
• K05.221 Aggressive periodontitis, generalized, slight
• K05.222 Aggressive periodontitis, generalized, moderate
• K05.223 Aggressive periodontitis, generalized, severe
• K05.229 Aggressive periodontitis, generalized, unspecified severity
• K05.311 Chronic periodontitis, localized, slight
• K05.312 Chronic periodontitis, localized, moderate
• K05.313 Chronic periodontitis, localized, severe
• K05.319 Chronic periodontitis, localized, unspecified severity
• K05.321 Chronic periodontitis, generalized, slight
• K05.322 Chronic periodontitis, generalized, moderate
• K05.323 Chronic periodontitis, generalized, severe
• K05.329 Chronic periodontitis, generalized, unspecified severity

Hope this helps!
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Guest
#3 Posted : Tuesday, June 13, 2017 4:27:37 PM(UTC)
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Guest

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Thank you, this is helpful and worth a shot since she has a referring physician.
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Guest
#4 Posted : Thursday, June 29, 2017 9:39:18 AM(UTC)
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Guest

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Thanks again, we received payment from her insurance company for additional prophy due to pregnancy!!
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courtneydsnow
#5 Posted : Friday, June 30, 2017 7:49:20 AM(UTC)
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courtneydsnow

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That's great news! Thanks for sharing your experience :)
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