The procedure code (e.g. 8231) plus the ICD-10 code (e.g. K08.1) for the dentist’s professional service provided, on each coding line, including the line 8099. The appropriate laboratory ICD-10 code (e.g. Z46.3) for each laboratory procedure code (e.g. 9331) listed beneath 8099
As such, a dentist is also obligated to select the appropriate diagnosis code for patient records and claim submission. It is quite possible that other diagnoses and their associated codes may be appropriate for a given clinical scenario. Figure 1 Diagnostic. Evaluations and Exams Figure 2. Preventive. Dental Prophylaxis for Adults and Children
The referral ICD-10 code supplied by the dentist, in the appropriate place (e.g. K08.1). ii. The ICD-10 code (Z46.3 or Z46.4, as appropriate) for each line item on the lab invoice. c. When the dentist submits a claim on behalf of the technician, the account must include:
Basic D4230 Anatomical crown exposure – four or more contiguous teeth or tooth bounded spaces per quadrant Yes Periodontal charting, narrative, and photo (if available Medical policy Periodontics (9.02.502)
Use of ICD-10 codes is supported by the American Dental Association. The ADA now includes both dental- and medical-related ICD-10 codes in its “CDT Code Book.” Dental schools have included the use of ICD-10 codes in their curricula to prepare graduating dentists for their use in practice.
D2392 Resin-based composite, two surfaces, posterior.
D6240 Pontic, porcelain fused to precious/high noble metal. (bridge units)
Code D2391 (one-surface posterior resin-based composite) explicitly states that it should be “used to restore a carious lesion into the dentin.” The rationale for the requirement that the lesion extends into dentin can be questioned.
D7280. surgical access of an unerupted tooth.
D0230. Intraoral periapical – each additional radiographic. image.
CDT Code. Description. D6205. Pontic – indirect resin-based composite.
D9222 for deep sedation/general anesthesia, initial 15 minutes.
D8090. Comprehensive ortho treatment Comprehensive ortho treatment of adult. dentition.
D0251 extra-oral posterior dental radiographic image. Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.
D1516. Space maintainer – fixed – bilateral, maxillary.
D7550. Partial ostectomy/sequestrectomy for removal of non-vital bone. D7560. Maxillary sinusotomy for removal of tooth fragment or foreign body.
Currently CPT® 76497 is the preferred cross code used to report cone beam scans (CBCT). This code reports both the image capture and interpretation/ report.
There is no unique procedure code for clear aligners, so reference the CDT codes used for conventional treatments, D8010 through D8090.
In this dental procedure code, a "white" or "tooth-colored" filling made of composite resin is used to repair damage on two surfaces of a posterior tooth. Such fillings are referred to as "tooth-colored" because of their unique ability to mirror the color, texture and luminescence of your own teeth.
The agency now covers CDT code D8695. Use this code for a client whose appliance was placed by an orthodontic provider not participating with the agency, or whose treatment was previously covered by another third-party payer, or both. Fee includes debanding only.
The 2022 edition of ICD-10-CM Z29.9 became effective on October 1, 2021.
Categories Z00-Z99 are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00 -Y89 are recorded as 'diagnoses' or 'problems'. This can arise in two main ways:
The Preventive Health Benefits and Coding Guidelines (Guidelines) provide additional information related to specific types of preventive services, as defined under the Patient Protection and Affordable Care Act, which may be covered under a Member’s Benefit Plan depending on factors such as grandfathered status, product type and anniversary date, and contraception exemptions. The terms and conditions of the written Benefit Plan govern the benefits available to Members, and the Guidelines do not guarantee coverage or payment for a particular service. Members should contact Member Services at the telephone number and address on the back of their Identification Card for further preventive services information.
Blue Cross Blue Shield of North Dakota (BCBSND) claims processing system has specific programming around ICD-10 preventive diagnosis codes. A professional claim submitted with a specific preventive diagnosis code, to each service (which the grid outlines below); at the line level will cause that line to process as a preventive benefit. Please note, it is appropriate to have both preventive and medical diagnosis codes on a claim. However, only the diagnosis code(s) appropriate for each service should be indicated at the line level.