DentalWriter Forum

Your central resource for DentalWriter posts, blogs, training resources, faq's, and more.

Notification

Icon
Error

New Topic Post Reply
Guest
#1 Posted : Thursday, July 6, 2017 3:21:29 PM(UTC)
Quote
Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 1,937

Was thanked: 16 time(s) in 15 post(s)
D0330 Panoramic film
D0363 Cone beam-3D multi img reconst
D7820 Closed reduction of dislocate
D7880 Occlusal Orthotic device

Can someone help me get the medical cross coding for these please

Edited by user Thursday, July 6, 2017 3:22:55 PM(UTC)  | Reason: Add information

courtneydsnow
#2 Posted : Thursday, July 6, 2017 3:57:46 PM(UTC)
Quote
courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
Posts: 1,611

Thanks: 39 times
Was thanked: 51 time(s) in 51 post(s)
Hi guest!

D0330
- panoramic radiographic image
Can be cross coded to:
70355 - Orthopantogram (eg, panoramic x-ray)


D0363
- Cone-Beam 3D multi image reconstruction

There is actually not currently a specific CPT code for CBCT……the closest CPT code is: 70486 - Computed tomography, maxillofacial area; without contrast material. Many offices have been using this for some time for CBCT, however, some medical insurers are auditing that code when used for CBCT because the description does not specify “cone beam”.

So, “76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional)” is a good CPT code to use, or, many medical insurers will process the “D” codes for procedures when there is not a specific CPT code available.

For example, here are the “D” codes from HealthPartner’s medical policy for “Cone-beam computed tomography (CT) scan for medically-related dental services”

D0363 - Cone-Beam 3D multi image reconstruction
D0364 - Cone beam CT capture and interpretation with limited field of view - less than one whole jaw
D0365 - Cone beam CT capture and interpretation with field of view of one full dental arc - mandible
D0366 - Cone beam CT capture and interpretation with field of view of one full dental arch
- maxilla, with or without cranium
D0367 - Cone beam CT capture with interpretation with field of view of both jaws, with or without cranium
D0368 - Cone beam CT capture and interpretation for TMJ series including two or more exposures
D0380 - Cone beam CT image capture with limited field of view - less than one whole jaw
D0381 - Cone beam CT image capture with field of view of one full dental arch - mandible
D0382 - Cone beam CT image capture with field of view of one full dental arch - maxilla, with or without cranium
D0383 - Cone beam CT image capture with field of view of both jaws, with or without cranium
D0384 - Cone beam CT image capture for TMJ series including two or more exposures

Here is a link to the full policy:
https://www.healthpartners.com/public/coverage-criteria/cone-beam-scan.htm


D7820 - closed reduction of dislocation
can be crosscoded to:
21480 - Closed treatment of temporomandibular dislocation; initial or subsequent
21485 - Closed treatment of temporomandibular dislocation; complicated (e.g., recurrent
requiring intermaxillary fixation or splinting), initial or subsequent


D7880
- occlusal orthotic device, by report

There is not a specific crosscode for D7880. If you are using this code to represent an appliance being used to treat TMD:

What we are finding is that the code that is most commonly accepted by medical insurers currently for TMD appliances since the S8262 discontinuation June 2015 is D7880. However, some insurers are accepting the other codes listed below as well:

D7899 - unspecified TMD therapy, by report

Or, if the medical insurer says they won’t process the “D” codes (most will these days, but you will run into a few that won’t), you can try:

E1399 - Durable medical equipment, miscellaneous
21299 - Unlisted craniofacial and maxillofacial procedure
21499 - Unlisted musculoskeletal procedure, head

A narrative report explaining the treatment accompanying the claim is recommended since they are all "by report", “unlisted”, or "miscellaneous" codes.

For example, Aetna's medical policy for Temporomandibular disorders lists D7880 as an accepted HCPCS code is criteria is met: http://www.aetna.com/cpb/medical/data/1_99/0028.html


Hope this helps!
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.