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Hi Judy! No problem we”re happy to help as much as possible 🙂 Starting off with the diagnosis code you listed: K08.409 – Partial loss of teeth, unspecified cause, unspecified class The oral surgeon may be able to assign a more specific diagnosis code (medical insurers tend to prefer the most specific diagnostic code available). Here are the other codes available in that category that based on what you described below, may be appropriate: 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 The insurer may also be looking for a diagnostic code describing the accident/trauma. Accident/trauma coding gets VERY specific, so if you could provide me some details about the accident/trauma I would be happy to offer you some coding options. (for example, there are different codes for if the patient slipped and fell vs being pushed, codes for vehicle accidents and falls from ladders, codes for assault and accidental injuries, etc etc). As for the procedure codes: The two codes you listed do seem sound: 76376 – 3D rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image post-processing on an independent workstation 99202 – Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; 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 to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family As for the implants: below are some commonly used CPT codes when billing oral implants to medical insurance: 21248 – Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3or less) 21249 – Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more) 20670 – Removal of implant due to complications (superficial) 20680 – Removal of implant due to complications (deep) 21210 – graft, bone; nasal, maxillary, or malar areas 21215 – graft, mandibular **use modifier -52 for reduced services when bone is not obtained from patient As for the restorative work – it does depend on what all services are included, but many restorative procedures actually do not have a specific CPT code available that describes the procedures, so the provider 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 they can use the CPT code below and include a narrative report describing the procedure: 41899 – Unlisted procedure, dentoalveolar structures Hope this helps!
Getting a couple of front teeth knocked out can be very physical and emotional. It’s important to have the correct medical diagnosis code so that the treatment plan and insurance claim are accurate. Just as when looking for an audio recording studio near me, accurate information is needed. Dental documentation should also be clear, detailed and be handled professionally.
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