Hi, patient got bone grafting procedure (D7953) to get dental implant placement however his dental insurance denied saying that this procedure is a medical benefit. So, I submit the claim to his Medical Insurance.Now medical insurance is asking the diagnosis code for this treatment. There is no accident or trauma. What could be the diagnosis code for medical?

P.S.: Treating dentist is an oral surgeon

Thanks
Gina

Hi, I am a patient that had an implant procedure approx. 5 years ago. However in October 2018 with xray It was found that the bone around the implant deteriorating thus I needed to have this re done. As a result my dental insurance see the new bone grafting as a medical procedure but the dentist that completed the procedure does not know what diagnosis code to use can you help us. The procedure code he used was D7953
Thank you, Leslie

Hi, I am a patient of a dentist. I was seen for the extraction of three upper molars. Pathology resulted in the erosion and perforation of the sinus floor bilaterally resulting in extensive mucositis/sinusitis/infection. Removal of the infected teeth resulted in sinus perforation on both sides. To avoid a prolonged infection and more rapid healing the dentist performed a socket graft/oral-astral closure.
The procedure was coded to D7921 collection and application of blood and to D7953 bone replacement graft for the dentist's billing purposes. These codes are not a benefit for my dental insurance and do not work medical billing. I have submitted a claim to Medicare and they are asking for ICD.9 or ICD.10 diagnosis codes.
Do you have any suggestions for a code for medical insurance reimbursement purposes?

Thank you for any suggestions you have

Joe

Hello,
I am a patient and looking to bill medical for my extractions and bone graft and sinus lift. I have gerd, Barrett’s esophagus and laryngopharyngitis reflux also. Which that effects my bone loss and why I now need graft and sinus lift. I will also need implant dentures after I heal. The placement for them. Please what codes are used to bill medical insurance.

Thank you
Jodi

Hi Guest!

Yes this thread is still active.

Hi Courtney!

I hope this message finds you well :)

I've been researching a ton in hopes of helping my oral surgeon and prosthodontist be able to code my medically necessary All 4 On implant surgery and implant creation and molding costs.

I have Multiple Autoimmune disease syndrome, Crohn's disease, Sjogren's Syndrome, and GERD that have caused me to have the oral health status of that of a 70-year-old and I'm only 38.

I've been getting fillings since the age of 6 due to the aggressiveness of my conditions, and as I've gotten older I've had to have very large and deep fillings placed in every tooth that I have remaining, or a root canal on many of them.

Currently, I'm having severe pain in 2 of my teeth that had root canals previously and are now broken with the gum line in between them inflamed. This issue with inflamed gums is also playing out all through my mouth and with all of my other remaining teeth with excessive bleeding as well.

Implants are necessary bc at this point I can't eat properly, and the only thing left to do for my remaining 23 teeth are extractions since my fillings are so huge and deep, and a majority already have root canals. Not to mention that with every major tooth procedure, I end up in the hospital with a Crohn's flare bc of the antibiotics and my digestive issues, or bc of the pain and stress associated with the procedures. So, getting All 4 On implants is actually preventing my health from deteriorating even further with each additional filling or root canal. Implants will handle all of my oral issues at once and provide me with a clean slate that is less likely to also endanger my health.

My treatment plan will include my oral surgeon who will handle all of the extractions and stud placement and a prosthodontist who will create and insert my temporary and permanent implants.

As you can imagine, I'm beyond frustrated with my oral situation as I've always attended the dentist and completed fillings and root canals as suggested, but now all of those fillings and root canals are too old and/or weak and need the next step of care in order to keep my health on par.

Is there any way you could guide me on the medical codes to use with my health insurance company Anthem Bluecross PPO, to have both my oral surgery or extraction of my remaining heavily damaged 23 teeth removed, and any implant preparations and fittings afterward?

Any guidance or help you can supply me with would be HUGELY appreciated, and ABSOLUTELY life-saving.
otherwise, I'm not sure that I can afford the implants even though they are clearly necessary for me to eat and function :(

Thanks SO much and please stay safe ;)

xo, Chana

Edited by user Friday, July 9, 2021 12:12:56 AM(UTC)  | Reason: Spelled name incorrectly

Hi Courtney!

I work at a Periodontal office and am filing a medical claim for a patient that fractured two teeth in the result of an accident/trauma. I'm trying to find the right coding options for him as we don't generally file medical.

The Dental coding for treatment is:
9248- Non-intravenous conscious sedation, D9248?
7210- Extraction #8 - Using code S02.5XXB (root was exposed after fracture)
7210- Extraction #9 - Using code S02.5XXA
7953- Bone Replacement for ridge aug # 8- I'm not sure which codes to use for these two? Future implant placement is hopeful.
7953- Bone replacement for ridge aug #9-
4266- Guided tissue generation #8- 41870 - Periodontal mucosal graft ?
4910- Periodontal maintenance.- D4910?

Could you give some guidance? Thanks so much!

Thank you so much Courtney!

The patient was actually stung by a wasp which caused anaphylactic shock and caused him to fall in his driveway on concrete and hit face first. He broke his nose and fractured his front teeth, breaking one off in the process.

BCBS wants my ICD-10 Code along with the procedure code
The ICD-10 code is KO8.21
I was given a procedure code of 21215.
Can you define that procedure fo me?