Post by NHAKHOA on Jan 13, 2018 18:56:27 GMT -5
dentalwriter.com/forum/default.aspx?g=posts&t=582
Q: because we are a dental office. don't have much to do with medical claims. But I have a pt. who was in an auto accident, she has m/care primary and BC as seconadary.
what ICD 10 coded is used ?
A: In order to bill Medicare for services related to an auto-accident, your doctor/practice will need to be enrolled as a Medicare Part B provider for your jurisdiction. (billing medicare for sleep apnea appliances would require that your practice enroll as a DME supplier)
Here is a fact sheet Medicare provides for more information on the enrollment process:
www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedEnroll_PhysOther_FactSheet_ICN903768.pdf
Here is a link to the Medicare Part B enrollment application, the 855i form:
www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855i.pdf
And as for what ICD-10 diagnosis code would be used, it all depends on the patient's condition, and the details of the accident they were involved in.
For example, if the patient experienced partial loss of teeth due to the accident, here are some ICD-10 coding options:
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
Or, for example if the patient is experiencing pain due to trauma:
G89.11 - Acute pain due to trauma
G89.21 - Chronic pain due to trauma
Or, perhaps the patient is experiencing TMD issues:
M26.61 - Adhesions and ankylosis of temporomandibular joint
M26.62 - Arthralgia of temporomandibular joint
M26.63 - Articular disc disorder of temporomandibular joint
M26.69 - Other specified disorders of temporomandibular joint
Now, as for the code to describe the accident, you will need more detail about the nature of the accident in order to determine the appropriate code, such as was the patient the driver or passenger, was the accident with another motor vehicle or something else, etc. Here are a few examples of accident ICD-10 codes:
V49.59XA - Passenger injured in collision with other motor vehicles in traffic accident, initial encounter
V49.59XD - Passenger injured in collision with other motor vehicles in traffic accident, subsequent encounter
V49.49XA - Driver injured in collision with other motor vehicles in traffic accident, initial encounter
V49.49XD - Driver injured in collision with other motor vehicles in traffic accident, subsequent encounter
V49.09XA - Driver injured in collision with other motor vehicles in nontraffic accident, initial encounter
V49.09XD - Driver injured in collision with other motor vehicles in nontraffic accident, subsequent encounter
********************
Q: A patient that was involved in a 4 wheeler accident losing 2 front teeth; she was driving and no other vehicle was involved. What should I use to describe this accident?
A: Here are some ICD-10 coding options for you:
For the accident:
V86.59XA - Driver of other special all-terrain or other off-road motor vehicle injured in nontraffic accident, initial encounter
V86.59XD - Driver of other special all-terrain or other off-road motor vehicle injured in nontraffic accident, subsequent encounter
V86.59XS - Driver of other special all-terrain or other off-road motor vehicle injured in nontraffic accident, sequela
For the partial loss of teeth:
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 .
*********************************
Q: a patient who was hit in the face by a softball. He lost the majority of his teeth. He has BCBS for his medical insurance. What codes do I need to use for this type of accident and for dental implants (single and bridged)?
A: As for the diagnosis code(s), here are some coding options:
W21.07XA - Struck by softball, initial encounter
W21.07XD - Struck by softball, subsequent encounter
W21.07XS - Struck by softball, sequela
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
As for the procedure code for the dental implants:
21248 Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial
21249 Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete.
Q: I need medical diagnosis and procedure codes for the following dental procedure codes to bill medical BCBS please.
D6104 bone graft at time of implant placement
D6010 surg placement of implant body: endosteal implant
D7250 surgical removal residual tooth roots (cutting procedure)
D9230 inhalation of nitrous okide/anxiolysis, analgesic
This is a result of an accident, a fall.
Q:
D6104 - bone graft at time of implant placement can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
21215 - graft, mandibular
**use modifier -52 for reduced services when bone is not obtained from patient
D6010 - surgical placement of implant body: endosteal implant can be crosscoded to:
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)
D7250 - surgical removal of residual tooth roots (cutting procedure)
The code listed above does not have a direct crosscode 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 try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
D9230 - inhalation of nitrous oxide / anxiolysis, analgesia CrossCode options:
00100 - Anesthesia for procedures on salivary glands, including biopsy
00102 - Anesthesia for procedures involving plastic repair of cleft lip
00160 - Anesthesia for procedures on nose and accessory sinuses; not otherwise specified
00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
00172 - Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
00176 - Anesthesia for intraoral procedures, including biopsy; radical surgery
00190 - Anesthesia for procedures on facial bones or skull; not otherwise specified
00192 - Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)
01999 - Unlisted anesthesia procedure(s)
As for the ICD-10 diagnosis code(s) to use, that will actually depend on the nature of the accident/fall! (there are different codes for is a patient slipped and fell, from one level to another or same level, if they her pushed, etc etc. So, if you could give me a bit more detail about how the fall happened I would be happy to help you out with some coding options.
Also - as for the injury to to the teeth/oral cavity, you'll want to assign an appropriate ICD-10 diagnosis code to represent that as well - what are we looking at there? (i.e. were teeth cracked, broken, lost (complete or partial), etc?
Q: because we are a dental office. don't have much to do with medical claims. But I have a pt. who was in an auto accident, she has m/care primary and BC as seconadary.
what ICD 10 coded is used ?
A: In order to bill Medicare for services related to an auto-accident, your doctor/practice will need to be enrolled as a Medicare Part B provider for your jurisdiction. (billing medicare for sleep apnea appliances would require that your practice enroll as a DME supplier)
Here is a fact sheet Medicare provides for more information on the enrollment process:
www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/MedEnroll_PhysOther_FactSheet_ICN903768.pdf
Here is a link to the Medicare Part B enrollment application, the 855i form:
www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855i.pdf
And as for what ICD-10 diagnosis code would be used, it all depends on the patient's condition, and the details of the accident they were involved in.
For example, if the patient experienced partial loss of teeth due to the accident, here are some ICD-10 coding options:
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
Or, for example if the patient is experiencing pain due to trauma:
G89.11 - Acute pain due to trauma
G89.21 - Chronic pain due to trauma
Or, perhaps the patient is experiencing TMD issues:
M26.61 - Adhesions and ankylosis of temporomandibular joint
M26.62 - Arthralgia of temporomandibular joint
M26.63 - Articular disc disorder of temporomandibular joint
M26.69 - Other specified disorders of temporomandibular joint
Now, as for the code to describe the accident, you will need more detail about the nature of the accident in order to determine the appropriate code, such as was the patient the driver or passenger, was the accident with another motor vehicle or something else, etc. Here are a few examples of accident ICD-10 codes:
V49.59XA - Passenger injured in collision with other motor vehicles in traffic accident, initial encounter
V49.59XD - Passenger injured in collision with other motor vehicles in traffic accident, subsequent encounter
V49.49XA - Driver injured in collision with other motor vehicles in traffic accident, initial encounter
V49.49XD - Driver injured in collision with other motor vehicles in traffic accident, subsequent encounter
V49.09XA - Driver injured in collision with other motor vehicles in nontraffic accident, initial encounter
V49.09XD - Driver injured in collision with other motor vehicles in nontraffic accident, subsequent encounter
********************
Q: A patient that was involved in a 4 wheeler accident losing 2 front teeth; she was driving and no other vehicle was involved. What should I use to describe this accident?
A: Here are some ICD-10 coding options for you:
For the accident:
V86.59XA - Driver of other special all-terrain or other off-road motor vehicle injured in nontraffic accident, initial encounter
V86.59XD - Driver of other special all-terrain or other off-road motor vehicle injured in nontraffic accident, subsequent encounter
V86.59XS - Driver of other special all-terrain or other off-road motor vehicle injured in nontraffic accident, sequela
For the partial loss of teeth:
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 .
*********************************
Q: a patient who was hit in the face by a softball. He lost the majority of his teeth. He has BCBS for his medical insurance. What codes do I need to use for this type of accident and for dental implants (single and bridged)?
A: As for the diagnosis code(s), here are some coding options:
W21.07XA - Struck by softball, initial encounter
W21.07XD - Struck by softball, subsequent encounter
W21.07XS - Struck by softball, sequela
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
As for the procedure code for the dental implants:
21248 Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial
21249 Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete.
Q: I need medical diagnosis and procedure codes for the following dental procedure codes to bill medical BCBS please.
D6104 bone graft at time of implant placement
D6010 surg placement of implant body: endosteal implant
D7250 surgical removal residual tooth roots (cutting procedure)
D9230 inhalation of nitrous okide/anxiolysis, analgesic
This is a result of an accident, a fall.
Q:
D6104 - bone graft at time of implant placement can be crosscoded to:
21210 - graft, bone; nasal, maxillary, or malar areas
21215 - graft, mandibular
**use modifier -52 for reduced services when bone is not obtained from patient
D6010 - surgical placement of implant body: endosteal implant can be crosscoded to:
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)
D7250 - surgical removal of residual tooth roots (cutting procedure)
The code listed above does not have a direct crosscode 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 try the CPT code below and include a narrative report describing the procedure:
41899 - Unlisted procedure, dentoalveolar structures
D9230 - inhalation of nitrous oxide / anxiolysis, analgesia CrossCode options:
00100 - Anesthesia for procedures on salivary glands, including biopsy
00102 - Anesthesia for procedures involving plastic repair of cleft lip
00160 - Anesthesia for procedures on nose and accessory sinuses; not otherwise specified
00170 - Anesthesia for intraoral procedures, including biopsy; not otherwise specified
00172 - Anesthesia for intraoral procedures, including biopsy; repair of cleft palate
00176 - Anesthesia for intraoral procedures, including biopsy; radical surgery
00190 - Anesthesia for procedures on facial bones or skull; not otherwise specified
00192 - Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)
01999 - Unlisted anesthesia procedure(s)
As for the ICD-10 diagnosis code(s) to use, that will actually depend on the nature of the accident/fall! (there are different codes for is a patient slipped and fell, from one level to another or same level, if they her pushed, etc etc. So, if you could give me a bit more detail about how the fall happened I would be happy to help you out with some coding options.
Also - as for the injury to to the teeth/oral cavity, you'll want to assign an appropriate ICD-10 diagnosis code to represent that as well - what are we looking at there? (i.e. were teeth cracked, broken, lost (complete or partial), etc?