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Now that S8262 has been discontinued, what code for Medical billing will work for a removable orthotic device? How would you submit a dental code ie:D7880 on a medical 1500 form?
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Hi guest!
Great question. What we are finding is that the code that is most commonly accepted currently for TMD appliances since the S8262 discontinuation is D7880. However, some insurers are accepting D7899, 21499, or E1399.
D7880 - occlusal orthotic device, by report
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
21499 - Unlisted musculoskeletal procedure, head
A narrative report accompanying the claim is recommended since they are all "by report" or "miscellaneous" codes.
You just submit the code on the CMS1500 in box 24 just like you would a CPT or HCPCS code! You still of course want to make sure you have your TMD diagnosis code(s) on the claim as well in box 21.
You can also check the insurers TMD medical policy on their website, and many of them will list accepted codes right in their policies.
Hope this helps, have a great day.
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Does this code apply if the appliance is to be worn on the maxillary?
Thank you for your help!
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Hi guest!
Yes it would, all the codes listed in the post above do not specify mandibular or maxillary, only "by report" or "miscellaneous":
D7880 - occlusal orthotic device, by report
D7899 - unspecified TMD therapy, by report
E1399 - Durable medical equipment, miscellaneous
21499 - Unlisted musculoskeletal procedure, head
Hope this helps, have a great day!
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Hello
I'm trying to find out if the D7880, D7899, E1399, 21499 are still current? I'm trying to submit a claim for TMJ treatment with DNA device, but am getting errors that either that E1399 or my dx code 26.00 for treatment of TMJ are not current.
Which dx code would I use?
Thanks for your guidance.
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Rank: Administration
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Hi guest!
Yes D7880 is currently the most commonly accepted code we see for TMD appliances for medical insurers (some insurers may prefer D7899, 21499, or E1399).
However, 26.00 is not a valid diagnosis code. The diagnosis codes for TMD's were updated and went into effect on October 1, 2016. Below is the list of diagnosis codes that were added & deleted:
Deleted Temporomandibular Disorder (TMD) ICD-10 codes:
• M26.60 Temporomandibular joint disorder, unspecified
• M26.61 Adhesions and ankylosis of temporomandibular joint
• M26.62 Arthralgia of temporomandibular joint
• M26.63 Articular disc disorder of temporomandibular joint
Added Temporomandibular Disorder (TMD) codes:
• M26.601 Right temporomandibular joint disorder, unspecified
• M26.602 Left temporomandibular joint disorder, unspecified
• M26.603 Bilateral temporomandibular joint disorder, unspecified
• M26.609 Unspecified temporomandibular joint disorder, unspecified side
• M26.611 Adhesions and ankylosis of right temporomandibular joint
• M26.612 Adhesions and ankylosis of left temporomandibular joint
• M26.613 Adhesions and ankylosis of bilateral temporomandibular joint
• M26.619 Adhesions and ankylosis of temporomandibular joint, unspecified side
• M26.621 Arthralgia of right temporomandibular joint
• M26.622 Arthralgia of left temporomandibular joint
• M26.623 Arthralgia of bilateral temporomandibular joint
• M26.629 Arthralgia of temporomandibular joint, unspecified side
• M26.631 Articular disc disorder of right temporomandibular joint
• M26.632 Articular disc disorder of left temporomandibular joint
• M26.633 Articular disc disorder of bilateral temporomandibular joint
• M26.639 Articular disc disorder of temporomandibular joint, unspecified side
No change:
M26.69 - Other specified disorders of temporomandibular joint
Hope this helps, have a great day!
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Rank: Guest
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Originally Posted by: courtneydsnow  Hi guest!
Yes D7880 is currently the most commonly accepted code we see for TMD appliances for medical insurers (some insurers may prefer D7899, 21499, or E1399).
However, 26.00 is not a valid diagnosis code. The diagnosis codes for TMD's were updated and went into effect on October 1, 2016. Below is the list of diagnosis codes that were added & deleted:
Deleted Temporomandibular Disorder (TMD) ICD-10 codes:
• M26.60 Temporomandibular joint disorder, unspecified
• M26.61 Adhesions and ankylosis of temporomandibular joint
• M26.62 Arthralgia of temporomandibular joint
• M26.63 Articular disc disorder of temporomandibular joint
Added Temporomandibular Disorder (TMD) codes:
• M26.601 Right temporomandibular joint disorder, unspecified
• M26.602 Left temporomandibular joint disorder, unspecified
• M26.603 Bilateral temporomandibular joint disorder, unspecified
• M26.609 Unspecified temporomandibular joint disorder, unspecified side
• M26.611 Adhesions and ankylosis of right temporomandibular joint
• M26.612 Adhesions and ankylosis of left temporomandibular joint
• M26.613 Adhesions and ankylosis of bilateral temporomandibular joint
• M26.619 Adhesions and ankylosis of temporomandibular joint, unspecified side
• M26.621 Arthralgia of right temporomandibular joint
• M26.622 Arthralgia of left temporomandibular joint
• M26.623 Arthralgia of bilateral temporomandibular joint
• M26.629 Arthralgia of temporomandibular joint, unspecified side
• M26.631 Articular disc disorder of right temporomandibular joint
• M26.632 Articular disc disorder of left temporomandibular joint
• M26.633 Articular disc disorder of bilateral temporomandibular joint
• M26.639 Articular disc disorder of temporomandibular joint, unspecified side
No change:
M26.69 - Other specified disorders of temporomandibular joint
Hope this helps, have a great day!
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