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Our dentist has recently underwent the training for laser periodontal treatment or Osseous surgery. Is this something that can go through medical? And if so, what medical code and diagnosis codes should we be using? We have the dental code of D4261 and D4260. Thanks!
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Joined: 11/21/2012(UTC) Posts: 1,611
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Hi jbublik!
There are not directly corresponding CPT (medical) codes for D4261 and D4260 that we are aware of. However, some medical insurers will actually process the "D" codes themselves on a medical claim, as although they are usually considered “Dental Codes”, they are actually found in the medical coding books, the HCPCS book. However, if the insurer does not accept "D" codes, CPT code 41899 can be used in their place. 41899 stands for: Unlisted Procedure, dentoalveolar structures Another option (since I’m not quite sure if the areas you’re working on are really considered part of dentoalveolar structures or not….): 40899 stands for: unlisted procedure, vestibule of mouth
Since these are a non-specific codes, you will want to include a description of what the procedures are for processing.
Hope this helps, have a great day!
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In doing research on the procedure my dentist has in one of my family member's treatment plan, I stumbled across your posting. Since my expertise is in data (governance, taxonomy, mapping, etc), perhaps my perspective could help. From the original post it sounds that the "codes" being used are the D4261 & D4260, with the differentiation being the number of teeth worked upon (i.e. 3 or less vs. 4 or more). Ignoring all the other minutia for a moment, the CPT code I found that was / is the closest match would be CPT code 41823, which I found on a data mapping table from the following URL >> https://www.medicaid.gov...cpt-to-cdt-crosswalk.pdfWhether this is applicable, I have not a whit, as each circumstance is unique. If my observation isn't helpful, please ignore.
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Rank: Administration
Joined: 11/21/2012(UTC) Posts: 1,611
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Hi Guest - Patrick Hickey!
Great observations! Yes I do agree that 41823 can be a valid crosscode for D4260 & D4261, although I am not quite sure that 41823 would be appropriate in this situation because jbublik had specified that the treatment they are looking at is laser treatment. The reason I say that is based on the descriptions of these codes:
D4261 - osseous surgery (including elevation of a full thickness flap and closure) - one to three contiguous teeth or tooth bounded spaces per quadrant
D4260 - Osseous surgery (including flap entry and closure) - four or more contiguous teeth or tooth bounded spaces per quadrant.
41823 - Excision of osseous tuberosities, dentoalveolar structures
.....so since 41823 specifies "excision" instead of laser treatment, I would be hesitant to use it for laser treatment. Although if the laser is performing excision it may be an appropriate code to use!
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