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tigertam
#1 Posted : Wednesday, December 12, 2012 4:11:07 PM(UTC)
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tigertam

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Joined: 12/12/2012(UTC)
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Hello,

My name is Tammy Anderson and I'm from Dr. Ettienne van Zyl's office in Collierville. We are trying to file a medical claim on a ct scan for a patient that needs an implant. Their dental denied it, so we promised the patient we'd try medical. Dr. van Zyl looked through the list of diagnosis codes, but was unable to find one that would work. The codes for the ct scan are D00362 and D00360. Could you possibly help us with this and maybe suggest some codes we can use?
courtneydsnow
#2 Posted : Thursday, December 13, 2012 1:16:51 PM(UTC)
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courtneydsnow

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Hi Tammy!

The CPT code for the CT scan when you submit to medical insurance (instead of your D codes) is:

70486 - Computed tomography, maxiollofacial area; without contrast material.

As far as the ICD-9 diagnosis code to use: the important thing to keep in mind is that the diagnosis code used will need to support that the implant was medically necessary in order for a medical insurer to cover it.

So why was this implant done? Accident? Atrophy? Etc? Diagnosis codes are very specific in nature.
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