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Guest
#21 Posted : Wednesday, April 13, 2022 7:53:44 AM(UTC)
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Guest

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Hello!

Patient had (2) implants on #7 & 10.
Procedure codes:
D6104
D6010
D7210
D6085
D6051
D0367
D0160

Attempting to submit to medical, need ICD10.

Backstory: Patient had ho pain/issue, xray detected fracture at root #7. Patient sent to Perio, new xray detected additional fracture also at root #10. No accident/injury, patient believes biting on xray plate may have cause damage?

Any advice?
courtneydsnow
#22 Posted : Wednesday, April 20, 2022 10:40:47 AM(UTC)
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courtneydsnow

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Hi Guest!

As for the CPT crosscodes for the procedures you listed:

D6104
- bone graft at time of implant placement
can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
21215 - graft, mandibular
**use modifier -52 for reduced services when bone is not obtained from 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)
(basically, if it was 3 or less implants, you'll use 21248 instead of 21249)


D0367 - Cone beam CT capture with interpretation with field of view of both jaws, with or without cranium

There is actually not currently a specific CPT code for CBCT……the closest CPT code is: “70486 - Computed tomography, maxillofacial area; without contrast material”. Many offices have been using this for some time for CBCT, and some insurers require this code to be used for CBCT (i.e. UHC). However, some medical insurers are auditing that code when used for CBCT because the description does not specify “cone beam”.

So, “76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional)” is an option to use (keep in mind you'll need to provide a narrative description for unlisted codes).


D0160 - detailed and extensive oral evaluation - problem focused, by report
can be crosscoded to one of the following Evaluation & Management (E&M) codes:
New patients:
99202 – 15-29 mins
99203 – 30-44 mins
99204 – 45-59 mins
99205 – 60-74 mins

Established patients:
99212 – 10-19 mins
99213 – 20-29 mins
99214 – 30-39 mins
99215 – 40-54 mins


D7210 - Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated
D6085 - provisional implant crown
D6051 - interim abutment

As for extractions, crowns & abutments, they do not have a 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



As for the ICD-10 diagnosis code(s), based on what you described, here are some coding options for you to consider:
K03.81 - Cracked tooth
Y65.8 - Other specified misadventures during surgical and medical care
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