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Guest
#1 Posted : Wednesday, March 11, 2020 12:26:47 PM(UTC)
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Guest

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I'm trying to get my TMJ Lysis & Lavage procedure covered by medical insurance but my oral surgeon's office submitted CDT codes to my medical insurance so it was obviously not approved. Could someone please help me? I am desperate.

I need the CPT codes that correspond to the following Dental codes:

D7871
D9999
D9222
D9223
D9612

I have been in a lot of pain for a long time so I greatly appreciate any help I can get, and I am on a time crunch. Trying to find a provider who could help me has been a 5 month long process and now trying to find out how to get it approved by my medical insurance has been an added frustration. I feel like my oral surgeon's office should know how to file for insurance benefits related to their procedures but they seem very incompetent.
courtneydsnow
#2 Posted : Thursday, March 12, 2020 1:02:15 PM(UTC)
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courtneydsnow

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Hi Guest!

D7871 - Non-arthroscopic lysis and lavage

Aetna's medical in nature oral surgery crosswalk indicate the crosscode for CPT for this procedure is:

20605 - Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance

Here is a link to the crosswalk i mentioned: https://www.aetnadental.com/professionals/pdf/oral-surgery-medical-in-nature.pdf


D9999 - unspecified adjunctive procedure, by report
*since this code stands for an unspecified procedure by report, you will want to find out what service this code is being used to represent from your doctor to find a good crosscode for it.


D9222 – deep sedation/general anesthesia – first 15 minutes
and
D9223 – deep sedation/general anesthesia – each additional 15 minutes
can be crosscoded to:
00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified


D9612 - therapeutic parenteral drugs, two or more administrations, different medications
can be crosscoded to:
96372 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
or
96373 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial
or
96374 - Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intravenous push, single or initial substance/drug


Hope this helps!
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