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Guest
#1 Posted : Friday, June 16, 2017 11:16:57 AM(UTC)
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Guest

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What CPT or Diagnostic code should we use when trying to submit a claim for an Occlusal Orthotic Device? We were told that D7880 isn't the proper code.
mbrzezinski
#2 Posted : Friday, June 16, 2017 4:02:50 PM(UTC)
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mbrzezinski

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Hi Guest,
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 of 2015 is D7880 - occlusal orthotic device, 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.

It may be best to look up the insurers medical policy for Temporomandibular disorders and check the coding section of the policy to see if a specific code they accept is listed. For example, Aetna's medical policy for Temporomandibular disorders lists D7880 as an accepted HCPCS code if criteria is met:
http://www.aetna.com/cpb...cal/data/1_99/0028.html

Hope this helps!
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