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What modifier is used when multiple frenoctomy areas are sent to medical?
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Hi Guest,
You can change the number of units for services provided and add the JO qualifier with the area or you can list it as two services completed each with the area the service was provided.
The following are the codes for areas of the oral cavity, reported with the JO qualifier:
• 00 : Entire oral cavity
• 01 : Maxillary arch
• 02 : Mandibular arch
• 10 : Upper right quadrant
• 20 : Upper left quadrant
• 30 : Lower left quadrant
• 40: Lower right quadrant
Hope this helps!
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We have a patient that is going to have frenectomies in 3 separate sites on the same day; upper & lower labial frenectomies and lower lingual frenecomty. We plan to bill dental insurance first and if denied submit to medical. When billing dental insurance would you advise to bill D7960 as 3 separate services on the same day as they are separate sites? Thanks for the help.
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Hi Eastland Dental Center! D7960 - frenulectomy - also known as frenectomy or frenotomy - separate procedure not incidental to another procedure Dental billing is not really our forte as medical insurance is, however I did find a few dental policies that may be helpful. Here is a link to Aetna's dental policy titled "Frenulectomy (Frenectomy, Frenotomy) or Frenuloplasty": https://www.aetna.com/health-care-professionals/clinical-policy-bulletins/dental-clinical-policy-bulletins/DCPB011.html#I did not find any indications in this policy that it cannot be billed as three separate procedures for three different sites. Also, here is a link to UHC's dental policy titled "ORAL SURGERY: NON-PATHOLOGIC EXCISIONAL PROCEDURES" https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Main%20Menu/Tools%20&%20Resources/Policies%20and%20Protocols/Dental%20Clinical%20Policies%20&%20Coverage%20Guidelines/StaticFiles_PDFs/Oral%20Surgery_Non-Pathologic.pdfUnder "Coverage Limitations and Exclusions" in this policy, it states: "Frenulectomy and frenuloplasty are considered incidental if performed on the same day, same area as gingivectomy/gingivoplasty, alveoloplasty and vestibuloplasty surgical procedures" So again, no direct indications it cannot be billed separately for separate sites, although it is possible the insurer may say that multiple sites performed on the same day are incidental to each other. Hope this helps! .
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Rank: Guest
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Trying to find the medical code for Frenulectomy D7960?
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Rank: Administration
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Hi Guest!
D7960 - frenulectomy
can be crosscoded to:
40819 - Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)
Hope this helps!
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