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Guest
#1 Posted : Monday, March 21, 2022 12:43:20 PM(UTC)
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Guest

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I work for a general dentist. We had a patient who came in with Trauma to her mouth. She was playing pickle ball and was hit in the mouth with a racket. Here is what we did.

Limited Exam D0140
Intraoral PA-Single D0220
Tooth Reimplantation D7270 tooth #24
Endo Therapy Anterior tooth #24 D3310
Resin Composite Filling 1 Surface Ant. #24 D2330
Athletic Mouth Guard D9941

Codes we used for Medical were
Diagnosis codes K08.419 and K04.1
CPT codes 70300, 99050, 41899

Are there any other codes I need to be using?
courtneydsnow
#2 Posted : Monday, March 21, 2022 3:49:17 PM(UTC)
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courtneydsnow

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Hi Guest!

Good work on the research there! Just a few bits of feedback:

1) For the diagnosis codes you listed:

K04.1 - Necrosis of pulp
K08.419 - Partial loss of teeth due to trauma, unspecified class

Here's a few other codes to consider, if they fit the situation/condition:
S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture
S02.5XXB - Fracture of tooth (traumatic), initial encounter for open fracture
S03.2XXA - Dislocation of tooth, initial encounter
G89.11 - Acute pain due to trauma


If you do end up using K08.419, I would recommend selecting of the more specific codes in the partial loss of teeth due to trauma category (insurers always prefer the more specific codes rather than unspecified):

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


As for the CPT codes you listed:

70300 - Radiologic examination, teeth; single view
99050 - Services provided in the office at time other than regularly scheduled office hours, or days when the office is closed (e.g., holidays Saturday or Sunday), in addition to basic service
41899 - Unlisted procedure, dentoalveolar structures

70300 is good for your D0220
41899 can apply to your D3310 and D2330. Some medical insurers will allow you to use the "D" code instead, since there are not direct crosscode from dental codes to medical codes for these two procedures.
the medical insurer will not likely cover the athletic mouthguard)
99050 is good to indicate your office visit happened outside of regular business hours, however you will need to use a "regular" office visit (E&M) code in conjunction with this code. Here are the options:

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


Hope this helps!
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