Viewing 10 posts - 1 through 10 (of 10 total)
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  • #256050
    niermanpm
    Participant

    Hi, 3 of my teeth that had supported a bridge for a long time eventually cracked and broke. One split into half all the way down to the root but was able to be pulled out. 2 of them broke at the gum line and required surgical extraction. I then had implants and a new bridge. All 3 teeth have had root canal done about 20 years ago and I think they broke simply due to wear and tear. I need to know what diagnosis code to use for my medical insurance claim for the cutting procedure. I looked through all the relevant Q&A in this forum but couldn”t find a similar situation for the iCD 10 code. Can you help? Thank you. JL

    #244246
    Jeremy Hobbs
    Keymaster

    I need help with correct medical codes for dental procedures

    #256049
    niermanpm
    Participant

    Hi JL! You will certainly want to confirm any diagnosis codes with your provider, but based on what you described, here are some coding options for you: K03.81 – Cracked tooth K08.3 – Retained dental root K08.531 – Fractured dental restorative material with loss of material K08.539 – Fractured dental restorative material, unspecified Hope this helps!

    #256174
    niermanpm
    Participant

    Hi Guest! You”re welcome. And no problem, here is a link to a presentation that provides more details on determination the class: Hope this helps!

    #256175
    niermanpm
    Participant

    Thank you, that does help. Can you tell me the difference between the classI, ClassII and ClassII in the ICD 10 codes K08.111, .112, and .113?

    #256176
    niermanpm
    Participant

    Hi Guest! Here are some coding options for you: 20670 – Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure) 20680 – Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate) Hope this helps!

    #256177
    niermanpm
    Participant

    Is there a CPT code for removal of infected maxillary subperiosteal implant? The closest I can find is 21299 for unlisted craniofacial and maxillofacial proceurues.

    #256178
    niermanpm
    Participant

    Hi JennS! No problem. So as you alluded to – not all implants cases meet the medical necessity requirements for medical insurance coverage. But, for the ones that do, here are some commonly used diagnosis coding options for what you described: Diagnosis: K08.21 – Minimal atrophy of the mandible K08.22 – Moderate atrophy of the mandible K08.23 – Severe atrophy of the mandible K08.24 – Minimal atrophy of maxilla K08.25 – Moderate atrophy of the maxilla K08.26 – Severe atrophy of the maxilla K12.2 – Cellulitis and abscess of mouth K04.6 – Periapical abscess with sinus K04.7 – Periapical abscess without sinus K04.1 – Necrosis of pulp K04.2 – Pulp degeneration K04.01 – Reversible pulpitis K04.02 – Irreversible pulpitis • K05.211 – Aggressive periodontitis, localized, slight • K05.212 – Aggressive periodontitis, localized, moderate • K05.213 – Aggressive periodontitis, localized, severe • K05.219 – Aggressive periodontitis, localized, unspecified severity • K05.221 – Aggressive periodontitis, generalized, slight • K05.222 – Aggressive periodontitis, generalized, moderate • K05.223 – Aggressive periodontitis, generalized, severe • K05.229 – Aggressive periodontitis, generalized, unspecified severity • K05.311 – Chronic periodontitis, localized, slight • K05.312 – Chronic periodontitis, localized, moderate • K05.313 – Chronic periodontitis, localized, severe • K05.319 – Chronic periodontitis, localized, unspecified severity • K05.321 – Chronic periodontitis, generalized, slight • K05.322 – Chronic periodontitis, generalized, moderate • K05.323 – Chronic periodontitis, generalized, severe • K05.329 – Chronic periodontitis, generalized, unspecified severity • K05.10 – Chronic gingivitis, plaque induced • K05.11 – Chronic gingivitis, non-plaque induced • K02.3 – Arrested dental caries • K02.51 – Dental caries on pit and fissure surface limited to enamel • K02.52 – Dental caries on pit and fissure surface penetrating into dentin • K02.53 – Dental caries on pit and fissure surface penetrating into pulp • K02.61 – Dental caries on smooth surface limited to enamel • K02.62 – Dental caries on smooth surface penetrating into dentin • K02.63 – Dental caries on smooth surface penetrating into pulp • K02.7 – Dental root caries • K02.9 – Dental caries, unspecified K03.81 – Cracked tooth 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 M26.34 – Vertical displacement of fully erupted tooth or teeth M26.33 – Horizontal displacement of fully erupted tooth or teeth Partial loss of teeth, due to periodontal diseases: o K08.421 – Partial loss of teeth due to periodontal diseases, class I o K08.422 – Partial loss of teeth due to periodontal diseases, class II o K08.423 – Partial loss of teeth due to periodontal diseases, class III o K08.424 – Partial loss of teeth due to periodontal diseases, class IV o K08.429 – Partial loss of teeth due to periodontal diseases, unspecified class Partial loss of teeth, due to caries: o K08.431 – Partial loss of teeth due to caries, class I o K08.432 – Partial loss of teeth due to caries, class II o K08.433 – Partial loss of teeth due to caries, class III o K08.434 – Partial loss of teeth due to caries, class IV o K08.439 – Partial loss of teeth due to caries, unspecified class Partial loss of teeth, due to trauma: 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 K08.419 – Partial loss of teeth due to trauma, unspecified class Partial loss of teeth, due to other specified cause: K08.491 – Partial loss of teeth due to other specified cause, class I K08.492 – Partial loss of teeth due to other specified cause, class II K08.493 – Partial loss of teeth due to other specified cause, class III K08.494 – Partial loss of teeth due to other specified cause, class IV K08.499 – Partial loss of teeth due to other specified cause, unspecified class Hope this helps!

    #256179
    niermanpm
    Participant

    Our oral surgery office does a lot of “All on 4″ implant cases. This involves full mouth extractions with alveoplasty in each quad, and placement of dental implants in an outpatient surgery center. I”m struggling with all the correct codes to send to medical insurance. Most of the time these surgeries are only due to decay in multiple areas, periodontal issues, or they are just unhappy with full dentures. The patient prefers to replace the existing teeth that already have a guarded prognosis with implants. It”s more of a “big picture” treatment plan. I appreciate your help!

    #265436
    Cameron Scott
    Participant

    I’m looking into major dental reconstruction with implants, and it honestly feels like a big decision with a lot of moving parts—bone health, planning, and timing all seem really important. I recently saw Arbor Dental Clinic mentioned while researching, and they seem to focus on detailed assessments before starting treatment, which makes sense for something this involved.

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