Hi Guest!

41870 stands for: Periodontal mucosal grafting

Z92.21 stands for: Personal history of antineoplastic chemotherapy

K06.0 stands for: Gingival recession

However, K06.0 is not a billable code as there are more specific codes available, which may be where BCBS is saying there is an incorrect code. Also, this code was marked for deletion for the 2017 ICD-10 coding updates, which went into effect October 1, 2017. The more specific coding options are as follows:

K06.010 - Localized gingival recession, unspecified
K06.011 - Localized gingival recession, minimal
K06.012 - Localized gingival recession, moderate
K06.013 - Localized gingival recession, severe
K06.020 - Generalized gingival recession, unspecified
K06.021 - Generalized gingival recession, minimal
K06.022 - Generalized gingival recession, moderate
K06.023 - Generalized gingival recession, severe


Hope this helps!

Hi Guest!

Modifier 50 stands for: Bilateral procedures.

I'm not sure you would need to use it to indicate upper & lower, I would just bill for 2 units of the code, and you can indicate in the supplemental information (the red shaded portion of the line item) that it it for both mandibular & maxillary using the "JO" qualifier.

Here is some additional information about the JO and JP qualifiers:

The following are the codes for tooth numbers, reported with the JP qualifier:
• 1 –32: Permanent dentition
• 51 –82: Permanent supernumerary dentition
• A –T: Primary dentition
• AS –TS: Primary supernumerary dentition

The following are the codes for areas of the oral cavity, reported with the JO qualifier:
• 00 : Entire oral cavity
• 01 : Maxillary arch
• 02 : Mandibular arch
• 10 : Upper right quadrant
• 20 : Upper left quadrant
• 30 : Lower left quadrant
• 40: Lower right quadrant

Examples of how this would look on the medical claim can be found in the NUCC's CMS 1500 claim form manual here, starting on page 46 & 47:
http://www.nucc.org/images/stories/PDF/1500_claim_form_instruction_manual_2012_02-v5.pdf


Hope this helps!

Edited by user Thursday, November 2, 2017 11:11:47 AM(UTC)  | Reason: Not specified