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#1 Posted : Thursday, February 18, 2021 5:24:55 PM(UTC)

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We have a work comp case and the patient was hit by a metal object. Fractured tooth #10. Tooth needs to be extracted, which was paid for already by work comp (extraction). But they are now asking for CPT codes for the Implant. We submitted as code 21248 and for ICD code I used W22.8.XXA is this correct?
#2 Posted : Monday, February 22, 2021 9:32:47 AM(UTC)

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Hi Guest!

Great work! 21248 is the correct CPT code for 3 or less implants.

As for the ICD (diagnosis) code, based on what you described I would first code the fracture of tooth:
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture

And this code may absolutely be the correct secondary code to describe the accident:
W22.8XXA - Striking against or struck by other objects, initial encounter

However if the metal object was thrown, projected or falling, you may instead consider:
W20.8XXA - Other cause of strike by thrown, projected or falling object, initial encounter

Or, for example, if the patient was hit intentionally by another person with a metal object, or accidentally during sports, etc - there are different codes for those situations.

Hope this helps!
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