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alex arango
#1 Posted : Tuesday, October 9, 2018 2:08:23 PM(UTC)
alex arango

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Joined: 6/6/2018(UTC)
Posts: 4

Hi,

I would like to submit for 10 implants, 4 in maxilla and 6 in mandible. Do I need to submit them as one for maxilla 21249x4 and one for mandible 21249x6, or can I submit them together as 21249X10? I just don't know if I can pool the two arches together.

Thank you
Guest
#2 Posted : Sunday, March 24, 2019 1:07:58 PM(UTC)
Guest

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Hi I have a few questions I hope you can help

Patient suffered a fall in the bath and hit the tub surrounding. It dislodged two implants on top and cracked the remaining lower. The doctor recommended the all on 4 or 6 permanents for both top and bottom. Medical insurance has approved it but im unsure sure how to make sure we will be compensated for procedures and such. As we don’t know the codes to submit. They will have to remove the top two implants and the remaining lowers. Then proceed. We also need to do a 3D scan prior to procedure also.

Any help will be greatly appreciated. Thanks
courtneydsnow
#3 Posted : Monday, March 25, 2019 8:28:30 AM(UTC)
courtneydsnow

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Hi Guest!

No problem - based on what you described, here are some diagnosis & procedure coding options:

ICD 10 diagnosis:

For the trauma:
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
K08.531 - Fractured dental restorative material with loss of material
K08.530 - Fractured dental restorative material without loss of material

For the fall:
W18.2XXA - Fall in (into) shower or empty bathtub, initial encounter
W18.2XXD - Fall in (into) shower or empty bathtub, subsequent encounter


CPT Procedure codes:

For the removal of implants:
20670 - Removal of implant due to complications (superficial)
20680 - Removal of implant due to complications (deep)

As for the 3D scan, it depends on what type of x-ray machine they are using, however here's a few common ones:
76102 - Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, mastoid polytomography), other than with urography; bilateral
70486 - Computed tomography, maxillofacial area; without contrast material
76497 - Unlisted computed tomography procedure (eg, diagnostic, interventional)

As for the subsequent implants:
21248 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial(3 or less)
21249 - Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete (4 or more)


Hope this helps!
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