Hi

I need ICD 10 procedure codes for:
D9243 intravenous conscious sedation (60 minutes)
A8 L-PRF w/implant/extraction
D6010 surg plae implant
D7210 extraction-surgical/erupt tooth
D6057 Custom abutment
D6058 implant crown zirconia

I also need ICD 10 diagnostic codes: tooth was extracted due to chronic infection (possible crack, failed root canal, chronic infection causing autoimmune disease.

thank you!

Hi Guest!

D9243 - Intravenous moderate (conscious) sedation/analgesia – each 15 minute increment

Below are the coding options for moderation sedation:

99151
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient younger than 5 years of age

99152
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older

99153
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; each additional 15 minutes intraservice time (list separately in addition to code for primary service)

99155
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger than 5 years of age

99156
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient age 5 years or older

99157
Moderate sedation services provided by a physician or other qualified health care professional other than the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports; each additional 15 minutes intraservice time (list separately in addition to code for primary service)


D6010 - surgical placement of implant body: endosteal implant
can be cross coded to:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3or less)
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)


D7210 - surgical removal of erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated
D6057 - custom fabricated abutment - includes placement
D6058 - abutment supported porcelain/ceramic crown

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), or you can use the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Now, as far as the diagnostic codes. These should be assigned by your doctor, but based on what you described, here are some possible coding options:

- K03.81 - Cracked tooth
- K08.59 - Other unsatisfactory restoration of tooth
- M27.51 - Perforation of root canal space due to endodontic treatment
- K12.2 - Cellulitis and abscess of mouth
- K04.01 - Reversible pulpitis
- K04.02 - Irreversible pulpitis
- K04.1 - Necrosis of pulp
- K04.2 - Pulp degeneration
- K04.3 - Abnormal hard tissue formation in pulp
- K04.4 - Acute apical periodontitis of pulpal origin
- K04.5 - Chronic apical periodontitis
- K04.6 - Periapical abscess with sinus
- K04.7 - Periapical abscess without sinus
- K04.8 - Radicular cyst
- K04.9 - Other and unspecified diseases of pulp and periapical tissues
- K04.90 - Unspecified diseases of pulp and periapical tissues
- K04.99 - Other diseases of pulp and periapical tissues
- K05.311 - Chronic periodontitis, localized, slight
- K05.312 - Chronic periodontitis, localized, moderate
- K05.313 - Chronic periodontitis, localized, severe
- K05.319 - Chronic periodontitis, localized, unspecified severity
- K05.321 - Chronic periodontitis, generalized, slight
- K05.322 - Chronic periodontitis, generalized, moderate
- K05.323 - Chronic periodontitis, generalized, severe
- K05.329 - Chronic periodontitis, generalized, unspecified severity
- K05.10 - Chronic gingivitis, plaque induced
- K05.11 - Chronic gingivitis, non-plaque induced
- B37.9 - Candidiasis, unspecified

Hope this helps!

Hi Guest!

D7240 - removal of impacted tooth - completely bony

The code listed above does not have a direct crosscode we are aware of, so you can either bill the "D" code on the CMS1500 medical claim (many insurers these days will process "D" codes when they are medically necessary services), or you may consider the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures

As for the modifier - there is not necessarily a "standard" modifier to use for extractions like there are some with services dental practices bill to medical insurance (i.e. sleep apnea appliances), but if there was something special or unique about the situation, you may end up using a modifier such as:
-52 - reduced services
-22 - unusual Procedural Services
-52 - multiple procedures

Now, as for the diagnostic pointer (field 24E) - that will simply be listed as a letter(s) - usually A, B, C, or D - but it depends on how many diagnosis codes you have listed in field 21, and which diagnoses are applicable to which services in field 24. For example, for impacted teeth, you may have the ICD-10 diagnosis code K01.1 (impacted teeth) listed in the blank labeled "A" in field 21. If that was the only diagnosis code on your claim, you would enter "A" into field 24E where it asks for the diagnosis pointer on the line item for the code you use for the extractions (either D7240 or 41899).

If medical billing is something you are going to be doing more of, it sounds like you're a perfect candidate for one of our successful medical billing in dentistry seminars! Here is a link to our full seminar schedule: https://niermanpm.com/dental-continuing-education/schedule

Hope this helps!

Hi j w!

The diagnosis code(s) to use when billing medical insurance for x-rays such as pano's & PA's will depend on why the x-rays are being taken. For example, if they are for evaluation for fabrication of a sleep appliance, you will likely use ICD10 G47.33 which stands for obstructive sleep apnea.
If it is a patient with a temporomandibular join disorder, those diagnostic codes range between M26.601-M26.69. If trauma, there are codes for trauma to teeth such as S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture.

If you have some additional information about the reason for the x-rays treatment, i would be happy to offer you some coding options.

Hi Guest!

D7410 - excision of benign lesion up to 1.25 cm

I actually don't believe that 11401 is the correct code for the service. Reason being, 11401 stands for:
Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm


Now, 11440 stands for:
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less


So *could* be the correct code depending on the location of the benign lesion (i.e. lip).

Or, you may consider these codes below if the location of the lesion is either the vestibule or the floor of the mouth:

40810 - Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair
40812 - Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair
40814 - Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair
40816 - Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle
41116 - Excision, lesion of floor of mouth


Hope this helps!

Hi Guest!

The diagnosis code(s) to use when billing medical insurance for x-rays such as pano's & PA's will depend on why the x-rays are being taken. For example, if they are for evaluation for fabrication of a sleep appliance, you will likely use ICD10 G47.33 which stands for obstructive sleep apnea.
If it is a patient with a temporomandibular join disorder, those diagnostic codes range between M26.601-M26.69. If trauma, there are codes for trauma to teeth such as S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture.

If you have some additional information about the reason for the x-rays, i would be happy to offer you some coding options.

Hi Guest!

D7451 - removal of benign odontogenic cyst or tumor - lesion diameter greater than 1.25 cm
can be crosscoded to:
21030 - Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage
21040 - Excision of benign tumor or cyst of mandible, by enucleation and/or curettage
21046 - Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])
21047 - Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])
41825 - Excision of lesion or tumor, dentoalveolar structures; without repair
41826 - Excision of lesion or tumor, dentoalveolar structures; with simple repair
41827 - Excision of lesion or tumor, dentoalveolar structures; with complex repair


Hope this helps!

I need diagnostic code for Three teeth pulled , procedure code D7210. Have to bill medical and dental office was no help

Hi Guest!


D7210 - Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated

As for the CPT code for extractions, there is actually not 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 use the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


For the ICD (diagnosis) code(s) - this will depend on your condition - in other words, why where the services performed?
For example, a common diagnostic code used for extraction is:
K01.1 - Impacted teeth

However, if the extractions were done for another reason (i.e. an accidental injury, tumor removal, etc) - if you'd like to provide some additional details on the condition that led to the extraction I am happy to offer some coding options.


Hope this helps!

Hi Guest!

D7953 - bone replacement graft for ridge preservation - per site
Can be cross coded to:
21210 - Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)
21215 - Graft, bone; mandible (includes obtaining graft)
**use modifier -52 for reduced services when bone is not obtained from patient


D7210 - Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated

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), or you can use the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Hope this helps!