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 : Thursday, August 3, 2017 2:20:11 PM(UTC)
Quote
Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 1,106

Was thanked: 16 time(s) in 15 post(s)
I need help please I have to file this claim myself and need medical codes for a dental claim.
The Dental codes I have are:
d9310
d9243
d9610
d7230
d7220
d7241
Any help would be awesome this claim is over a year old and I would just like to get it taken care of I just found out I needed cross codes.
Thank You very much!
Mrs. Weldon
courtneydsnow
#2 Posted : Friday, August 4, 2017 8:26:16 AM(UTC)
Quote
courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
Posts: 1,463

Thanks: 39 times
Was thanked: 47 time(s) in 47 post(s)
Hi Mrs. Weldon!

D9310 - consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician
Can be crosscoded to:
• 99241 - Office consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
• 99242 - Office consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.


D9243 - Intravenous moderate (conscious) sedation/analgesia – each 15 minute increment

Here are some coding options below:

00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
00172 - Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
00174 - Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor
00176 - Anesthesia for intraoral procedures, including biopsy; radical surgery
01999 - Unlisted anesthesia procedure(s)


D9610 - therapeutic parenteral drug, single administration
can be cross coded to:
96374 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug


D7230 - removal of impacted tooth - partially bony
D7220 - removal of impacted tooth - soft tissue
D7241 - removal of impacted tooth - completely bony, with unusual surgical complications

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 try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures

Hope this helps!
Guest
#3 Posted : Monday, August 7, 2017 9:31:05 AM(UTC)
Quote
Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 1,106

Was thanked: 16 time(s) in 15 post(s)
Hi, I need help converting dental codes to medical codes. D3310, D2950, D9940, D2335,D0230,D1040.
if there is no conversion, what code would use then?

Please I need your help, I've been going back and forth with the insurance company since Sept!!
courtneydsnow
#4 Posted : Monday, August 7, 2017 10:43:44 AM(UTC)
Quote
courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
Posts: 1,463

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

D0230 - intraoral - periapical each additional radiographic image
Can be cross coded to:
70310 - Radiologic examination, teeth; partial examination, less than full mouth



D3310 - endodontic therapy anterior tooth (excluding final restoration)
D2950 - core buildup, including any pins when required
D2335 - resin-based composite - four or more surfaces or involving incisal angle (anterior)

The codes listed above do not have a direct crosscode 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 try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


D1040 - did you mean D0140?


For D9940 - occlusal guard, by report

There is not a specific crosscode for D9940. If you are using this code to represent an appliance being used to treat temporomandibular disorders (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 - occlusal orthotic device, by report. 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
Guest
#5 Posted : Monday, August 7, 2017 1:21:48 PM(UTC)
Quote
Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 1,106

Was thanked: 16 time(s) in 15 post(s)
Thank you so much for your help, what codes should I list for the diagnosis..just send a narrative?
courtneydsnow
#6 Posted : Monday, August 7, 2017 2:46:16 PM(UTC)
Quote
courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
Posts: 1,463

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

The diagnosis code(s) will depend on the condition that prompted the services to be done. It is always best to get the diagnosis code(s) from your doctor/dentist.

For example, if the reason the service were done was partial loss of teeth, here are some coding options:

Partial loss of teeth, due to trauma:
o K08.411 - Partial loss of teeth due to trauma, class I
o K08.412 - Partial loss of teeth due to trauma, class II
o K08.413 - Partial loss of teeth due to trauma, class III
o K08.414 - Partial loss of teeth due to trauma, class IV
o K08.419 - Partial loss of teeth due to trauma, unspecified class

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

Partial loss of teeth, due to other specified cause:
o K08.491 - Partial loss of teeth due to other specified cause, class I
o K08.492 - Partial loss of teeth due to other specified cause, class II
o K08.493 - Partial loss of teeth due to other specified cause, class III
o K08.494 - Partial loss of teeth due to other specified cause, class IV
o K08.499 - Partial loss of teeth due to other specified cause, unspecified class

Partial loss of teeth, unspecified cause:
o K08.401 - Partial loss of teeth, unspecified cause, class I
o K08.402 - Partial loss of teeth, unspecified cause, class II
o K08.403 - Partial loss of teeth, unspecified cause, class III
o K08.404 - Partial loss of teeth, unspecified cause, class IV
o K08.409 - Partial loss of teeth, unspecified cause, unspecified class


If the services were done for another reason/condition, let me know and I would be happy to offer you some coding options.
Guest
#7 Posted : Wednesday, May 13, 2020 5:53:20 PM(UTC)
Quote
Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 1,106

Was thanked: 16 time(s) in 15 post(s)
Hello,

I need help finding the diagnosis medical code for (dental code) D9310. I read on your website that the CPT code for this is 99241.
I also wanted to know if the diagnosis medical code for 9610 is Z51.81? For this one I read that the CPT code is 96374.
I also do not the diagnosis medical code for D9239 (first 15min) and D9243 (additional).
Thank you in advance for your help, I would really appreciate it.

Best,

Adriana
courtneydsnow
#8 Posted : Thursday, May 14, 2020 2:56:39 PM(UTC)
Quote
courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
Posts: 1,463

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

You got it, D9310 can be crosscoded to 99241 or 99242 (some medical insurers no longer recognize codes 99241-99245, so if that is the case with your insurer, you will instead use 99201 or 99202 for a new patient, or 99211 or 99212 for an established patient)

D9610 - therapeutic parenteral drug, single administration
can be cross coded to:
96374 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug

D9239 - Intravenous moderate (conscious) sedation/anesthesia – first 15 minutes
can be cross coded to:
99152
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older


D9243 - Intravenous moderate (conscious) sedation/analgesia – each 15 minute increment
can be crosscoded to:
99153
Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; each additional 15 minutes intraservice time (list separately in addition to code for primary service)


As for the diagnosis code(s) - that will all depend on why these services are happening.
Z51.81 stands for: Encounter for therapeutic drug level monitoring

So, in order to offer you some coding options, i'll just need more detail on what condition(s)/symptom(s) are involved. For example, there are diagnosis codes for trauma to teeth, infections, cysts, abscesses, etc.

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.