Medical code for recession that happened while a pt was in cancer treatment. I used 41870.

[niermanpm]

How do we bill a upper and lower? 41870 for both or 41870 upper 41870-50 lower?

[niermanpm]

Hi Guest! Modifier 50 stands for: Bilateral procedures. I”m not sure you would need to use it to indicate upper & lower, I would just bill for 2 units of the code, and you can indicate in the supplemental information (the red shaded portion of the line item) that it it for both mandibular & maxillary using the “JO” qualifier. Here is some additional information about the JO and JP qualifiers: The following are the codes for tooth numbers, reported with the JP qualifier: • 1 –32: Permanent dentition • 51 –82: Permanent supernumerary dentition • A –T: Primary dentition • AS –TS: Primary supernumerary dentition 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 Examples of how this would look on the medical claim can be found in the NUCC”s CMS 1500 claim form manual here, starting on page 46 & 47: Hope this helps!

[niermanpm]

Had a pt have recession 1-tooth while she was in cancer treatment. Checked with Gd, no prior history of any recession, anywhere. Pt feels the cancer treatment she was under contributed to recession. BCBS has denied this claim, saying the code 41870 is an incorrect code. I also used ICD-10 Z92.21 and K06.0 I am really at a loss. Is there a correct CPT code or not? Please help!!! Julie

[niermanpm]

Hi Guest! 41870 stands for: Periodontal mucosal grafting Z92.21 stands for: Personal history of antineoplastic chemotherapy K06.0 stands for: Gingival recession However, K06.0 is not a billable code as there are more specific codes available, which may be where BCBS is saying there is an incorrect code. Also, this code was marked for deletion for the 2017 ICD-10 coding updates, which went into effect October 1, 2017. The more specific coding options are as follows: K06.010 – Localized gingival recession, unspecified K06.011 – Localized gingival recession, minimal K06.012 – Localized gingival recession, moderate K06.013 – Localized gingival recession, severe K06.020 – Generalized gingival recession, unspecified K06.021 – Generalized gingival recession, minimal K06.022 – Generalized gingival recession, moderate K06.023 – Generalized gingival recession, severe Hope this helps!

[Jeremy Hobbs]

recession on 1 tooth, ckd with GD, no History of recession prior to treatment.

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