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shemen9
#1 Posted : Thursday, February 25, 2016 6:02:36 PM(UTC)
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shemen9

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Hello,

I have a patient that fell out of her travel trailer, hit her face on a table, breaking 8-10. The proposed treatment is to place crowns on all three teeth. No endo or splinting is needed. This accident happened back in September 2015.

What codes would I use for this claim?

Thanks for your help as always
courtneydsnow
#2 Posted : Friday, February 26, 2016 7:29:50 AM(UTC)
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courtneydsnow

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Hi shemen9!

No problem!
If the services were rendered by your office after October 1, you will use the ICD-10 diagnosis codes. If the services were rendered by your office back in Spetember 2015, let me know and I will covert these into ICD-9 code for you.

Here are some ICD-10 diagnosis coding option for you:
W17.89XA - Other fall from one level to another, initial encounter
W10.8XXA - Fall (on) (from) other stairs and steps, initial encounter
V69.3XXA - Occupant (driver) (passenger) of heavy transport vehicle injured in unspecified nontraffic accident, initial encounter
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
K03.81 - Cracked tooth

As for the crowns, there is not a specific CPT code we are aware of, so you can either use the appropriate "D" code on the medical claim (many insurers these days will process the "D" codes when the service are medically necessary and there is not a direct crosscode available), or you can try the CPT code below, be sure to include a narrative report since it is a non-specific code:
41899 - Unlisted procedure, dentoalveolar structures

Hope this helps, have a great day!
shemen9
#3 Posted : Monday, February 29, 2016 6:03:21 PM(UTC)
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shemen9

Rank: New Member

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Thanks for your help!

I notice that you have stated that many insurers allow for D codes. How do I actually enter them on a claim form? Dental writer will not allow me to enter a D code.

The ICD-10 codes will work in this case as the crowns have not been placed yet.

courtneydsnow
#4 Posted : Tuesday, March 1, 2016 8:41:46 AM(UTC)
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courtneydsnow

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Hi shemen9!

Great question. There are many "D" codes already part of the DW default code list, but for any that are not, you can add them and use them on your claims and you can customize them into your visits/forms as well if you wish!

Instructions to do so below:

- Start by going to the “setup” menu on the main screen, choose “codes/fees”, then “CPT Codes”

- Then, just click the “new CPT code” code button in the window that appears, and type the code, description, and a default fee if you wish. Then save & close….once that is done, you can now add the code to claim forms, and you can customize the code into your visits/forms so you can click them as completed services if you want too

Hope this helps, have a great day!
 1 user thanked courtneydsnow for this useful post.
shemen9 on 3/3/2016(UTC)
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