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Hi there.
Does anyone know how to bill medical insurance to cover all-on-4 implants?
The patient had damage to her bridge after an accident, and her bottom bridge has an infection underneath with numbness to her face, which will cause her to lose that bridge as well. She also has gastric reflux which is causing dental issues too coupled with can’t breathe because her sinuses need lifting.
Are there 1st, secondary codes I need to submit? She’s in a lot of pain and we think she’s a good candidate for the all-on-4. We just don’t want to fail her by not submitting it properly for approval.
Regards,
Confused
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Rank: Administration
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Hi Confused! :)
Based on what you described, here are some coding options for you:
Diagnosis (ICD-10) options:
K12.2 - Cellulitis and abscess of mouth
K08.531 - Fractured dental restorative material with loss of material
K08.539 - Fractured dental restorative material, unspecified
K08.52 - Unrepairable overhanging of dental restorative materials
G89.11 - Acute pain due to trauma
G89.21 - Chronic pain due to trauma
K21.0 - Gastro-esophageal reflux disease with esophagitis
K21.9 - Gastro-esophageal reflux disease without esophagitis
J32.0 - Chronic maxillary sinusitis
**you will also want to use a code to describe the accident. Accident codes are extremely specific (i.e. fall due to tripping, fall from being pushed, various vehicle accidents, being hit by an object, etc etc). So, if you can give me more details about the nature of the accident, i'm happy to offer you some coding options.
Procedure codes:
Implants:
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)
Bone grafts:
21210 - graft, bone; nasal, maxillary, or malar areas
21215 - graft, mandibular
**use modifier -52 for reduced services when bone is not obtained from patient
Hope this helps!
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