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Hi Guest! For the conscious sedation, as long as the patient is over 5 years of age and the same provider who performed the extractions adminstered the sedation, here are the crosscodes below (if the patient was under 5 or if sedation performed by a different provider, let me know and I am happy to provide you those codes): D9239 – Intravenous moderate (conscious) sedation/anesthesia – first 15 minutes D9243 – Intravenous moderate (conscious) sedation/analgesia – each 15 minute increment can be crosscoded to: 99152 Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient age 5 years or older and 99153 Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; each additional 15 minutes intraservice time (list separately in addition to code for primary service) D7240 – Removal of impacted tooth – completely bony D7230- Removal of impacted tooth – partially bony D7220 – Removal of Impacted tooth, soft tissue D7110 – extraction – single tooth As for the CPT code for extractions, there is actually not 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 code below and include a narrative report describing the procedure: 41899 – Unlisted procedure, dentoalveolar structures Hope this helps!
My son is experiencing condylar resorption (Diagnosis M26.623). His condyle is disintegrating and likely eventually closing his airway. We are seeing a dentist who believes that Advanced Lightwire Functional (ALF) appliance will help to correct the deformities that caused the condylar resorption and open his airway. I have the following dental codes. Would someone be able to give me the medical codes so that we could try to get medical insurance to cover some of the costs? I was able to get some codes but cannot locate codes for these: D0140 Detailed and extensive oral exam D0290 anterior-posterior skull film D0350 oral and facial photographs D0470 diagnostic casts Thanks so much for any help! Jill
Hi Guest! I have listed the codes below in this message that are listed in Aetna’s medical policy for botox (the most common ones used for dental practices are J0585 and 64615) and a link to the Aetna medical policy on Botox: Botox Type A: HCPCS codes: • J0585 – Botulinum toxin type A, per unit • J0586 – Injection, Abobotulinumtoxina, 5 units • J0588 – Injection, incobotulinumtoxinA, 1 unit CPT Codes: • 64611 – Chemodenervation of parotid and submandibular salivary glands, bilateral • 64612 – Chemodenervation of muscles(s); muscles(s) innervated by facial nerve, unilateral (eg, for blepharospasm, hemifacial spasm) • 64615 – Chemodenervation of muscles(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg, for chronic migraine) • 64616 – Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) • 64617 – larynx, unilateral, percutaneous (eg, for spasmodic dysphonia), includes guidance by needle electromyography, when performed • 64653 – Chemodenervation other area(s) (e.g., scalp, face, neck), per day • 95873 – Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) • 95874 – Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) Botox Type B: HCPCS Code: • J0587 – Botulinum toxin type B, per 100 units CPT Codes: • 64616 – Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg, for cervical dystonia, spasmodic torticollis) • 95873 – Electrical stimulation for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) • 95874 – Needle electromyography for guidance in conjunction with chemodenervation (List separately in addition to code for primary procedure) Hope this helps!
Thanks. I used: D0473 – accession of tissue, gross and microscopic examination, preparation and transmission of written report I hope I don”t have to file again. If I do, I would probably go with D0502, but hopefully this will do. I really appreciate your help. Patient”s shouldn”t be made to file their own claims w/procedure codes–this should be the responsibility of the treating doctor/dentist/etc. -AC
Hi. I”m trying to submit this to my Dental Insurance, so I”m looking for the CDT code (not the medical codes), since they pay it at 100%. All I have is a diagnostic Code from the lab: D10.39 I”m looking for the code for doing the pathology on the biopsy. Since these are 2 separate claims. The biopsy was conducted (and filed) by the oral surgeon, but the pathology is from an independent lab. The OS submitted their claim, but I have to submit the Lab claim myself. I saw there were some pathology lab codes on my dental insurance”s website. perhaps it is D0473 Accession of tissue, gross and microscopic examination, preparation and transmission of written report The lab billing department told me their procedure code was: 88342 I”m not sure if that is internal to their lab or an actual billing code. -AC
Hi. Any help would be appreciated. My son had a soft tissue biopsy of the roof of his mouth by an oral surgeon. The excised tissue was sent to a lab that doesn”t process dental insurance. The procedure code they gave me was: D10.39 (I”m guessing ICD-10-CM) Benign neoplasm of other parts of mouth I am trying to submit this pathology report to my dental insurance but cannot find the appropriate billing code or a website that converts them. The procedure code from the Oral Surgeon was D7286 Incisional Biopsy of Oral Tissue – Soft They submitted the tissue to a lab (unfortunately out of plan, in another state). According to my benefits, my insurance should still cover this at 100%, but no one will submit this for me. Not the doctor. Not the lab. Please advise. Thank you!
Hi Jill! D0140 – limited oral evaluation – problem focused can be crosscoded to: 99202 – level 2 new patient Evaluation & Management (office visit) or 99212 – level 2 established patient Evaluation & Management (office visit) D0290 – this is actually not a valid code. Did you perhaps mean one of the following below? D0220 – intraoral – periapical first radiographic image D0230 – intraoral – periapical each additional radiographic image D0240 – intraoral – occlusal radiographic image D0250 – extra-oral – 2D projection radiographic image created using a stationary radiation source, and detector D0270 – bitewing – single radiographic image D0350 – 2D oral/facial photographic image obtained intra-orally or extra-orally D0470 – diagnostic casts can be crosscoded to: 99070 – special supplies & materials Hope this helps!
Hi AC! Sorry, did you mean that you are looking for the medical (CPT) code for this biopsy procedure? If so: D7286 – incisional biopsy of oral tissue-soft Here are some CPT cross coding options for you depending on the location in the oral cavity of the biopsy: 40490 – Biopsy lip 40808 – Biopsy, vestibule of mouth 41108 – Biopsy of floor of mouth 41110 – Biopsy of tongue, anterior two-thirds 41105 – Biopsy of tongue, posterior one-third 42100 – Biopsy of palate, uvula Hope this helps!
Hi AC! Ah ok – dental coding is not our forte here like medical coding is, but hopefully this information is helpful: 88342 is a medical CPT code, which stands for: Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure And here are some coding options from the oral pathology section of dental codes that may be applicable: D0472 – accession of tissue, gross examination, preparation and transmission of written report D0473 – accession of tissue, gross and microscopic examination, preparation and transmission of written report D0474 – accession of tissue, gross and microscopic examination, including assessment of surgical margins for presence of disease, preparation and transmission of written report D0476 – special stains for microorganisms D0477 – special stains, not for microorganisms D0478 – immunohistochemical stains D0482 – direct immunofluorescence D0483 – indirect immunofluorescence D0502 – other oral pathology procedures, by report Hope this helps!
Hi joel! D7260 – oroantral fistula closure can be crosscoded to: 30580 – repair fistula; oromaxillary D7560 – maxillary sinusotomy for removal of tooth fragment or foreign body can be crosscoded to: 31020 – Sinusotomy, maxillary (antrotomy); intranasal 31030 – Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of antrochoanal polyps Hope this helps!
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