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Hi Guest!
There is a place of service code for ASC that can be used on the CMS1500 medical claim form: place of service code “24” stands for “Ambulatory Surgical Center” (instead of 11 which stands for office) - this would be entered into field 24B on the line items of the claim. There is also a modifier that can be used: the "SG" modifier in block 24D of line items on a claim indicates "Ambulatory surgery center (ASC) facility service"
Hope this helps!
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Is there a cpt code & Diagnosis code for Ambulatory surgery center ?
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Hi Guest!
D7951 - sinus augmentation with bone or bone substitutes via a lateral open approach
can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
*use -52 modifier for reduced services when bone is not obtained from the patient
Hope this helps!
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Hi,
Can any one help me with the correct medical code for sinus augmentation( dental procedure )
thanks
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Hi Candice!
Yes you are correct on the procedure codes for bone grafts and implants:
21210 - graft, bone; nasal, maxillary, or malar areas (includes obtaining graft)
21215 - Graft, bone; mandible (includes obtaining graft)
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)
As for diagnosis codes for bone loss (atrophy) and aggressive periodontitis:
K08.21 - Minimal atrophy of the mandible
K08.22 - Moderate atrophy of the mandible
K08.23 - Severe atrophy of the mandible
K08.24 - Minimal atrophy of maxilla
K08.25 - Moderate atrophy of the maxilla
K08.26 - Severe atrophy of the maxilla
K05.211 - Aggressive periodontitis, localized, slight
K05.212 - Aggressive periodontitis, localized, moderate
K05.213 - Aggressive periodontitis, localized, severe
K05.219 - Aggressive periodontitis, localized, unspecified severity
K05.221 - Aggressive periodontitis, generalized, slight
K05.222 - Aggressive periodontitis, generalized, moderate
K05.223 - Aggressive periodontitis, generalized, severe
K05.229 - Aggressive periodontitis, generalized, unspecified severity
As for "use modifier 52" when it comes to bone grafts - modifier 52 is typically used when bone substitute is used for the graft rather than the bone being obtained/harvested from the patient. Since the bone grafting codes description's specify "includes obtaining graft" modifier 52 stands for "reduced services" to indicate the bone was not obtained from the patient.
Hope this helps!
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I am looking for some CPT and Dx codes. I lost all my teeth and had to have bone graphs done on top and bottom. I have had two implants put in but need more. Here is what I have so far if you can confirm and provide missing needed information.
Bone Graph 21210 & 21215 Need DX code
Implant 21248 & 21249
This was due to bone loss from Aggressive Periodontitis also what is " use modifier 52" mean
Candice
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Hi Guest! No problem - here is a link to a presentation that goes more into detail! https://www.prosthodontics.org/assets/1/7/ACP_PDI_Partial_Edentulism1.pdf
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Can you dive into a little about the Classes and how to differentiate between them?
For example:
Partial loss of teeth, due to periodontal diseases:
o K08.421 - Partial loss of teeth due to periodontal diseases, class I
o K08.422 - Partial loss of teeth due to periodontal diseases, class II
o K08.423 - Partial loss of teeth due to periodontal diseases, class III
o K08.424 - Partial loss of teeth due to periodontal diseases, class IV
o K08.429 - Partial loss of teeth due to periodontal diseases, unspecified class
Partial loss of teeth, due to caries:
o K08.431 - Partial loss of teeth due to caries, class I
o K08.432 - Partial loss of teeth due to caries, class II
o K08.433 - Partial loss of teeth due to caries, class III
o K08.434 - Partial loss of teeth due to caries, class IV
o K08.439 - Partial loss of teeth due to caries, unspecified class
Thanks!
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Hi Jen!
The diagnosis code(s) to use depends on the patient's condition.... basically - what is the condition/reason the services are being done?
For example, if the sinus lift is being performed due to atrophy, here are the mild, moderate, and severe ICD-10 diagnosis codes for atrophy of the mandible and maxilla:
K08.21 - Minimal atrophy of the mandible
K08.22 - Moderate atrophy of the mandible
K08.23 - Severe atrophy of the mandible
K08.24 - Minimal atrophy of maxilla
K08.25 - Moderate atrophy of the maxilla
K08.26 - Severe atrophy of the maxilla
If the sinus lift is being performed for a different reason/condition, let me know and I am happy to help you with some coding options.
Hope this helps!
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