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Joined: 9/8/2012(UTC)
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Hello,
My father needs a implant according to my dentist "due to non-restorable caries after crown removal." The dentist said he will need a implant but my dad can't afford that and has health insurance not dental. Unfortunately, his dentist doesn't bill through medical so they weren't able to help us beyond giving us the dental insurance code (D6010) and I have been searching for someone else. After going through this forum it looks like the ICD 10 code our future dentist will probably use is K08.439 and the CPT code will be 21248.
However, the problem isn't just the tooth though... My dad can't properly chew or swallow because of intense pain and a few missing teeth on the same side of his mouth. He had a accident a few years back that resulted in a traumatic brain injury. Due to that injury he can't handle pain very well so when his mouth suddenly hurts it freaks him out and he ends up choking while eating. This has caused him to avoid food which is really worrying me. So my question is whether or not the problem with chewing and swallowing would affect the code that needs to be used. Is it even worth mentioning to the oral surgeon when I find them? Thanks for any advice you can give!
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Guest!
You've got it - it does sound like 21248 would likely be the appropriate procedure code. K08.439 may certainly be one of the diagnosis codes that the future provider would select, although K08.431-K08.434 are more specific codes to use from that category.
And yes absolutely - the issues with mastication are certainly a good thing to include in your medical insurance request, as that information many times takes the case into the medically necessary arena, instead of the dental. There are diagnosis codes available for feeding difficulties and dysphasia to represent this issue, and also can be further explained in a narrative report.
Hope this helps!
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