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Guest
#1 Posted : Monday, August 28, 2017 11:38:06 AM(UTC)
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Guest

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I have a 4 year old child that tripped on a playground structure and hit her upper lip and teeth. We saw her for a limited exam D0140 and an x-ray D0220, the patient will need to return after her swelling has subsided to have 2 primary teeth extracted D7111. Could someone help me out with the most appropriate CPT codes for those services and ICD 10 codes? Thanks in advance!
courtneydsnow
#2 Posted : Monday, August 28, 2017 2:14:55 PM(UTC)
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courtneydsnow

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Hi Guest!

No problem. For the diagnosis codes, here are some coding options for you:

For the damage to teeth & lip:
K03.81 - Cracked tooth
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
S01.511A - Laceration without foreign body of lip, initial encounter

For the trip & fall:
W09.0XXA - Fall on or from playground slide, initial encounter
W09.1XXA - Fall from playground swing, initial encounter
W09.2XXA - Fall on or from jungle gym, initial encounter
W09.8XXA - Fall on or from other playground equipment, initial encounter


As for the procedure codes:

D0140
- limited oral evaluation - problem focused
Can be crosscoded to:
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.
or
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.


D0220 - intraoral - periapical first radiographic image
can be cross coded to:
70300 - Radiologic examination, teeth; single view


D7111 - extraction, coronal remnants - deciduous tooth

The code listed above does not have a direct crosscode 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), or you can try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Hope this helps!

Edited by user Monday, August 28, 2017 3:43:21 PM(UTC)  | Reason: Not specified

Guest
#3 Posted : Monday, August 28, 2017 3:11:36 PM(UTC)
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Thank you so much for your quick response!!
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