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Hi I need help!! My son had an accident last month. He fell from the skateboard and badly damaged his 2 front teeth #8 and #9. The dentist only provided me the dental codes and told me to search online for the medical codes to claim my health insurance. Here are the codes the dentist uses:
D3220 Therapeutic Pulpotomy
D3310 Root Canal Therapy
D2335 Composits/ incisal angle
Since I already paid the dentist service in cash, he basically doesn't care and just provided me the receipt with the D codes. My health insurance provide me an reimbursement form but not the CMS 1500. I tried to search the proper medical code to use and here are what I find:
CPT 99215 for an established patient
E885.2 Fall from skateboard 41899 - Unlisted procedure, dentoalveolar structures include a narrative report describing the procedure)
Where I can find the medical codes for the D codes above? I feel like I'm stuck in between my health insurance and the dentist and both don't want to help me!! It's a big amount and the insurance said the accident injury is covered but now I don't how to claim!! Thanks very much for your help!
Regards,
Poyee
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Hi Poyee!
No problem we are happy to help in any way we can! As for the procedure code(s) -
D3220 - therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction and application of medicament
D3310 - endodontic therapy anterior tooth (excluding final restoration)
D2335 - resin-based composite - four or more surfaces or involving incisal angle (anterior)
The codes listed above do not have direct crosscodes we are aware of, so you can either bill the "D" code on the medical claim (many insurers these days will process "D" codes when they are medically necessary services), or you can use the CPT code below (as you had mentioned - good detective work!) and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
As for the diagnosis code(s), great find but you won't want to use E885.2, that code was retired in 2015 and replaced with a new code: V00.131A - Fall from skateboard, initial encounter
You will also want to offer code(s) for the trauma to the teeth/oral cavity, here are some commonly used ones below - depending on the damage that was done:
K03.81 - Cracked tooth
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
S03.2XXA - Dislocation of tooth, initial encounter
M26.34 - Vertical displacement of fully erupted tooth or teeth
M26.33 - Horizontal displacement of fully erupted tooth or teeth
Hope this helps!
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Thanks Courtney! Do you know if I can provides these codes to the insurance by myself? My dentist refused to help in anyway even talk to my medical insurance. Also what is difference between open and closed fracture? Thanks very much!
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Hi Guest!
It is typically best if the dentist chooses the diagnosis code(s) for you based on their evaluation of you, but if you are able to match the dentist's notes to a specific code or codes, you can certainly offer those to your medical insurer.
As for open and closed fractures, according to healthline.com - "A closed fracture is also called a simple fracture. In a closed fracture, the broken bone doesn't break your skin. ... In an open fracture, the ends of the broken bone tear your skin."
Hope this helps!
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Rank: Guest
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通过跟Paper代写 http://australiaway.org/a/paperdaixie/ 机构的在线客服的交流来对其专业性进行评判：回复是否准时、态度好坏，没有客服的代写机构直接排除。
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Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 2,249
Was thanked: 16 time(s) in 15 post(s)
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通过跟网课代上 http://www.wangkedaixiu.com/wkds/ 机构的在线客服的交流来对其专业性进行评判：回复是否准时、态度好坏，没有客服的机构直接排除。
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