Nierman Practice Management Logo
Follow us on Facebook
Follow us on Twitter
Connect with us on Linked In
View demos and More on You Tube
DentalWriter Software Logo 1-800-879-6468
Login   Register Here

Notification

Icon
Error

New Topic Post Reply
Guest
#1 Posted : Wednesday, May 8, 2019 10:47:07 AM(UTC)
Quote
Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 1,095

Was thanked: 16 time(s) in 15 post(s)
Hi-

I am in an Oral & Maxillofacial surgery office where we mostly do Orthognathic surgery and joint replacements. We bill medical insurance for surgery. The Doctor does pre-surgical planning using a CBCT and digital (optical scan) models. Then a surgical splint is printed by a company using a 3D printer. WE are needing to know how we can bill and get reimbursed for the fabrication and surgical planning. Currently, we use CPT 21085, however im trying to figure out if there is a better/additional code that will reimburse for the surgeons time for the planning session. Would it be considered a DME?? We have to pay the planning company for the splint ahead of time.

Thank you!
courtneydsnow
#2 Posted : Monday, May 13, 2019 11:50:56 AM(UTC)
Quote
courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
Posts: 1,318

Thanks: 39 times
Was thanked: 47 time(s) in 47 post(s)
Hi Guest!

Great question. 21085 stands for: Impression and custom preparation; oral surgical splint

This code does typically include the preparation & fabrication of the splint, and we do not typically see it categorized as DME.

A code you may consider for the additional planning time is:

99358 - Prolonged evaluation and management service before and/or after direct patient care; first hour

The notes on this code indicate: Report this service if the provider spends time in either preparation or evaluation of the outcome of treatment before or after the face–to–face encounter with a patient.

Hope this helps!

Guest
#3 Posted : Monday, May 13, 2019 1:32:17 PM(UTC)
Quote
Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 1,095

Was thanked: 16 time(s) in 15 post(s)
Yes, we use 21085 currently for the fabrication/preperation of the splint! Thank you so much for your reply, i think 99358 is EXACTLY what we are looking for!

You're amazing! I appreciate it!
Quick Reply Show Quick Reply
New Topic Post Reply
Forum Jump  
You can post new topics in this forum.
You can reply to topics in this forum.
You can delete your posts in this forum.
You can edit your posts in this forum.
You cannot create polls in this forum.
You can vote in polls in this forum.