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Hi, I was hoping this forum could help me with billing issues. I had a 5x5mm nodule removed from the dorsal right side of my tongue and the dr office said they could bill it as medical but now tell me I have to do and won”t give me codes. Can someone help me translate these to medical codes so I can get covered under Blue Cross. Specialist consultation for a DMD maxofacial surgeon 9310 Biopsy of oral tissue-soft 7286 thank you for any help you can provide and I will look back at the site for a possible answer, andy
Hi Andy! D9310 – consultation – diagnostic service provided by dentist or physician other than requesting dentist or physician Can be crosscoded to: • 99241 – Office consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient”s and/or family”s needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family. or • 99242 – Office consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient”s and/or family”s needs. Usually, the presenting problem(s) are of low severity. Typically, 30 minutes are spent face-to-face with the patient and/or family. D7286 – incisional biopsy of oral tissue-soft Since you indicated it was your tongue, you are likely looking at one the following two options: 41110 – Biopsy of tongue, anterior two-thirds 41105 – Biopsy of tongue, posterior one-third Hope this helps!
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