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Hello,
We have a patient that tripped over tram tracks and impacted tooth #8 about 2mm with alveolar fracture. We repositioned the tooth back close to pre-injury position and splinted it in place with composite to #7 & #9. Dental Code D7670 was billed to dental insurance along with code D2332 = #8 MIF composite filling of fractured tooth.
Is it possible to bill both medical insurance and dental insurance in this situation? Is it best to bill dental insurance first or medical insurance first? Or does it depend on the carrier?
This patient is coming back for a root canal (D3310) and then post (D2954) and crown (D2740). As this is necessary due to the accident would it also be appropriate to bill medical insurance or dental insurance?
Thank you so much for your help!
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Rank: Advanced Member
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Hi Eastland Dental Center!
In an accident case I would bill the medical ins first. If medical denies any of the services I would then submit to dental.
Hope this helps!
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 1 user thanked mbrzezinski for this useful post.
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Thanks for the response!
As far as diagnostic codes for the patient’s fall, would you recommend an additional ICD code be needed with S02.5XXA - Fracture of tooth (traumatic), initial encounter for closed fracture? The patient tripped and fell on a tram track while walking in Texas when visiting her son. Also, since the accident happened in another state, would there be anything else we would need to indicate on the medical claim form for this?
When billing medical insurance for multiple x-rays, is it appropriate to use 2 separate codes CPT 70300 & CPT 70310 with two different fees like when billing dental insurance code D0220 for a PA and D0230 for an additional x-ray? Or would medical consider the 2 x-ray codes reported on the same claim form mutually exclusive?
I understand how to list a tooth number with the JP qualifier on the medical claim form for example when billing the filling, dental code D2332 for tooth #8 however, do we also need to report the surfaces to medical insurance when billing the MIF filling? If so, how do we report tooth surfaces on the medical claim form?
Thanks for all of your help!!
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Hi guest!
Yes the code you listed for traumatic fracture of tooth looks good, and yes I would also recommend a code to represent for the accident itself. From what you described below, here is an ICD-10 coding option for you:
W01.198A - Fall on same level from slipping, tripping and stumbling with subsequent striking against other object, initial encounter
And yes, it is appropriate to bill 70300 and 70310 on the same claim as long as both x-rays were taken:
70300 - Radiologic examination, teeth; single view
70310 - Radiologic examination, teeth; partial examination, less than full mouth
There is not currently a specific way to report surfaces to medical insurers that we are aware of, you could include that information in the red shaded line on the line item of the claim or include it in your narrative report.
Hope this helps!
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1 user thanked courtneydsnow for this useful post.
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