Hi Guest!

Here are the descriptions for the CPT codes you listed:

20605 - Arthrocentesis, aspiration and/or injection; inter-mediate joint or bursa (e.g., temporomandibular)
21010 - Arthrotomy, temporomandibular joint
21050 - Condylectomy, temporomandibular joint
21060 - Meniscectomy, partial or complete, temporomandibular joint
21070 - Coronoidectomy
21073 - Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)
21240 - Arthroplasty, temporomandibular joint, with or without autograft
21242 - Arthroplasty, temporomandibular joint, with allograft
21243 - Arthroplasty, temporomandibular joint, with prosthetic joint replacement
29800 - Arthroscopy, temporomandibular joint, diagnostic
29804 - Arthroscopy, temporomandibular joint, surgical
21116 - Injection procedure for temporomandibular joint arthrography
21499 - Unlisted musculoskeletal procedure, head
21299 - Unlisted craniofacial and maxillofacial procedure


So - for the "D" codes/services you listed, there really aren't any matches there (except perhaps 21499 or 21299 in certain situations), as most of the above CPT codes are surgical in nature.


For D9940 - occlusal guard, by report

There is not a specific crosscode for D9940. If you are using this code to represent an appliance being used to treat TMD:

What we are finding is that the code that is most commonly accepted by medical insurers currently for TMD appliances since the S8262 discontinuation June 2015 is D7880 - occlusal orthotic device, by report. However, some insurers are accepting the other codes listed below as well:

D7899 - unspecified TMD therapy, by report

Or, if the medical insurer says they won’t process the “D” codes (most will these days, but you will run into a few that won’t), you can try:

E1399 - Durable medical equipment, miscellaneous
21299 - Unlisted craniofacial and maxillofacial procedure
21499 - Unlisted musculoskeletal procedure, head

A narrative report explaining the treatment accompanying the claim is recommended since they are all "by report", “unlisted”, or "miscellaneous" codes.

For example, Aetna's medical policy for Temporomandibular disorders lists D7880 as an accepted HCPCS code is criteria is met: http://www.aetna.com/cpb/medical/data/1_99/0028.html


For D0470 - diagnostic casts
that can be crosscoded to:
99070 - special supplies & materials
A4580 - cast supplies (e.g. plaster)

However, many medical insurers consider casts included in the reimbursement for the oral device itself for sleep apnea and TMD treatment.


D9950 - occlusion analysis - mounted case
D9943 - Occlusal guard adjustment

The codes listed above do not have direct crosscodes we are aware of, so you can either bill the "D" code on the medical claim (many insurers these days will process "D" codes when they are medically necessary services), but for the medical insurers who won't accept the "D" codes, you can try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


D0150 - comprehensive oral evaluation - new or established patient

The above code can be cross codes to an evaluation and management (E&M) CPT code. Since the above code is limited to oral evaluation (1 body system), you will likely be looking at the level 1 & 2 options. Here are the options below for new and established patient visits:

New patients:

99201 - Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.

99202 - Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family

99203 - Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.

99204 - Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family

99205 - Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.

Established Patients:

99211 - Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. Typically, 5 minutes are spent performing or supervising these services.

99212 - Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.

99213 - Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.

99214 - Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.

99215 - Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family


Hope this helps, have a great day!