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Guest
#1 Posted : Tuesday, August 10, 2021 12:58:06 PM(UTC)
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Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 2,247

Was thanked: 16 time(s) in 15 post(s)
So grateful I have found this site. My periodontist's office is horrible. They do no know how to cross code therefore they offer nothing in terms of help. The procedures I had may indeed be covered by my medical coverage, but I have no one to help me.

I had a tooth pulled and a bone graft in December 2020. Codes are: D7210 and D7953.

Just had implant and major sinus lift on 8/4/21. Codes are D7951 and D6010.

Any help you can offer would be great. I feel like I have to take a course in this to get anywhere. I am so frustrated and this entire procedure cost nearly $7,000 so anything that medical will pay will help me.

Courtney Snow, I so hope you are still responding here.

Thank you!
courtneydsnow
#2 Posted : Wednesday, August 11, 2021 8:18:57 AM(UTC)
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courtneydsnow

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Hi Guest!

Yes, I am here! :)

D7953 - bone replacement graft for ridge preservation - per site
Can be cross coded to:
21210 - Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)
21215 - Graft, bone; mandible (includes obtaining graft)
**use modifier -52 for reduced services when bone is not obtained from patient


D7951 - sinus augmentation with bone or bone substitutes via a lateral open approach
can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
*use -52 modifier for reduced services when bone is not obtained from the patient


D6010
- surgical placement of implant body: endosteal implant
can be cross coded to:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3 or less)


D7210 - Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated

Extractions actually do not have direct crosscode - 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 use the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


Hope this helps!
 1 user thanked courtneydsnow for this useful post.
m1z on 8/11/2021(UTC)
m1z
#3 Posted : Wednesday, August 11, 2021 7:07:35 PM(UTC)
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m1z

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Joined: 8/10/2021(UTC)
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I thanked you in the other answer you provided to me, but I wanted to thank you here as well!
courtneydsnow
#4 Posted : Friday, August 13, 2021 9:13:43 AM(UTC)
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courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
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Hi m1z!

Aw thanks, it's my pleasure :)
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