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Guest
#1 Posted : Wednesday, October 23, 2019 10:44:40 PM(UTC)
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Guest

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Need help for the medical billing for dental codes D4260.D4244,D4263 and D7210. Also like to know what are the diagnostic codes for the same.
Thank you
courtneydsnow
#2 Posted : Thursday, October 24, 2019 7:17:31 AM(UTC)
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courtneydsnow

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Hi Guest!

No problem. I don't show that D4244 is a valid CDT code - did you mean something else?

D4260 - osseous surgery (including flap entry and closure) - four or more contiguous teeth or bounded teeth spaces per quadrant
can be crosscoded to:
41874 - Alveoloplasty, each quadrant (specify)


D4263 - bone replacement graft - first site in quadrant
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


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

Extractions do not have direct crosscodes we are aware of, 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 codes below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures


As for the diagnostic codes - that all depends on that patient's condition/why the services are being done. For example, if is for partial loss of teeth, here are some coding options:

Partial loss of teeth, due to periodontal diseases:
o K08.421 - Partial loss of teeth due to periodontal diseases, class I
o K08.422 - Partial loss of teeth due to periodontal diseases, class II
o K08.423 - Partial loss of teeth due to periodontal diseases, class III
o K08.424 - Partial loss of teeth due to periodontal diseases, class IV
o K08.429 - Partial loss of teeth due to periodontal diseases, unspecified class

Partial loss of teeth, due to caries:
o K08.431 - Partial loss of teeth due to caries, class I
o K08.432 - Partial loss of teeth due to caries, class II
o K08.433 - Partial loss of teeth due to caries, class III
o K08.434 - Partial loss of teeth due to caries, class IV
o K08.439 - Partial loss of teeth due to caries, unspecified class

Partial loss of teeth, due to trauma:
K08.411 - Partial loss of teeth due to trauma, class I
K08.412 - Partial loss of teeth due to trauma, class II
K08.413 - Partial loss of teeth due to trauma, class III
K08.414 - Partial loss of teeth due to trauma, class IV
K08.419 - Partial loss of teeth due to trauma, unspecified class

Partial loss of teeth, due to other specified cause:
K08.491 - Partial loss of teeth due to other specified cause, class I
K08.492 - Partial loss of teeth due to other specified cause, class II
K08.493 - Partial loss of teeth due to other specified cause, class III
K08.494 - Partial loss of teeth due to other specified cause, class IV
K08.499 - Partial loss of teeth due to other specified cause, unspecified class


If you would like to provide more detail on the patient's condition I would be happy to help with some diagnostic coding options.

Hope this helps!
Guest
#3 Posted : Thursday, October 24, 2019 10:51:59 PM(UTC)
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Thank you
Guest
#4 Posted : Thursday, October 24, 2019 11:01:19 PM(UTC)
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Guest

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I need help with D4266 not for D4244 it's typo.Thanks
mbrzezinski
#5 Posted : Friday, October 25, 2019 2:39:47 PM(UTC)
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mbrzezinski

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Hi Guest,

D4266 - guided tissue regeneration - resorbable barrier, per site
can be cross coded to:
41870 - Periodontal mucosal grafting

Hope this helps!
Guest
#6 Posted : Wednesday, October 30, 2019 8:01:47 PM(UTC)
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Hi, I wanted to see if the medical insurance really pays with no problem for all codes above? My husband will be undergoing bonegrafting & sinus grafting, and we are trying to convince the dentist to bill it to medical.
courtneydsnow
#7 Posted : Monday, November 4, 2019 8:27:04 AM(UTC)
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courtneydsnow

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Hi Guest!

No you do not want to assume that bone grafts and sinus lifts (or any codes listed in these forums) will be covered no problem by your medical insurance. Patient's policies vary in coverage, and each medical insurer has its own medical coverage policies that stipulate what criteria patients must meet in order for a treatment/procedure to be considered medically necessary - you can find these on your insurer's website in many cases! For example - here is a link to Aetna's medical policy titled "Dental Services and Oral and Maxillofacial Surgery: Coverage Under Medical Plans":
http://www.aetna.com/cpb/medical/data/1_99/0082.html

It is important to verify benefits for these procedures, and submit a pre-authorization request and wait for the approval if required by your insurer.

Hope this helps!
Guest
#8 Posted : Thursday, March 18, 2021 9:45:38 AM(UTC)
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Guest
#9 Posted : Thursday, March 18, 2021 9:47:32 AM(UTC)
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D4261 code meaning
Guest
#10 Posted : Thursday, March 18, 2021 9:49:12 AM(UTC)
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courtneydsnow
#11 Posted : Friday, March 19, 2021 11:21:44 AM(UTC)
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courtneydsnow

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Hi Guest!

D4261 - osseous surgery (including elevation of a full thickness flap and closure) - one to three contiguous teeth or tooth bounded spaces per quadrant
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