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I am new to the medical billing world! We had a patient come into our dental office yesterday after he fell in the middle of the night and broke off 5 of his anterior teeth. 3 of the teeth were normal teeth, however, 2 of the teeth were implant crowns that broke off. The implants themselves are still in the maxilla, just the crowns showed trauma. I am wondering if we can bill medical for the two implant crown removals under the same code (41899) or if we cannot bill those to medical? Would you also happen to know what the code is for an alveloplasty?
Thanks,
Amanda
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Hi Amanda H!
41874 - Alveoloplasty, each quadrant (specify)
As far as billing the trauma to medical, yes many medical insurers do offer coverage for services due to accidents/trauma, but it will depend on the medical policy for the specific insurer.
Are you set to go on the diagnostic codes?
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I have these diagnostic codes:
S09.93xA
S02.5xxA
R68.84
(He knocked out 3 natural teeth so not sure if I use the code K08.112 here)
W01.1xxA
There are additional codes I can use like S00.531A, S00.532A, K04.0. I'm not sure if you can add too many codes.
Thanks
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Hi Amanda H!
S09.93XA - Unspecified injury of face, initial encounter
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
R68.84 - Jaw pain
If you don't think that:
K08.112 - Complete loss of teeth due to trauma, class II
is a good description for the condition, here are some additional options for you:
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
K08.419 - Partial loss of teeth due to trauma, unspecified class
I don't show that W01.1XXA is a valid diagnosis code - did you perhaps mean one of the following below?
W01.0XXA - Fall on same level from slipping, tripping and stumbling without subsequent striking against object, initial encounter
W01.10XA - Fall on same level from slipping, tripping and stumbling with subsequent striking against unspecified object, initial encounter
A medical claim allows up to 12 diagnosis codes, so if the others are applicable, you can certainly enter them on the claim.
S00.531A - Contusion of lip, initial encounter
S00.532A - Contusion of oral cavity, initial encounter
K04.0 is not a specific code, so if using you would want to select one of the specific ones below:
K04.01 - Reversible pulpitis
K04.02 - Irreversible pulpitis
Hope this helps!
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Rank: Guest
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Thanks for all the info.
This is what I have put, in this order. Let me know if my order of diagnostic codes need to be switched
S09.93xA
S02.5xxA
K08.111
R68.84
W01.10xA
S00.531A
S00.532A
I'm left wondering about the two fractured implant crowns if those are considered extractions or not. If they are not, Im not sure how to code those. The implant are fine and remained in the bone but the implant crowns, abutments/healing caps had to be removed.
Im also not seeing the icd-10 code for the alveoloplasty (41874). Is that possibly an old code?
Thanks
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