The Old Baseball-In-The-Mouth Routine

The dentist offered to meet her patient at the office on a Saturday afternoon after learning that the baseball connected with her patient’s mouth instead of the catcher’s mitt. The patient arrived with two chipped teeth, #8 in a cup of salt water, and a cold compress on his swollen lacerated lip. A periapical was taken to rule out the possibility of a root tip or foreign debris in the socket, and a Panorex was taken to verify that the jaw was not fractured. Interdental wiring/splinting was necessary to stabilize the tooth after it was reimplanted, and the lip was sutured. The chipped teeth will be restored after the lip heals, and now it’s time to submit the initial claim to the patient’s medical insurance. Here are your codes:

ICD-9 Diagnosis Codes:

873.73 Tooth (broken) (due to trauma) (complicated) (in this case, avulsed)873.43 Open wound of lip without mention of complicationsE917.0 S truck accidentally by hit or thrown ball (in sports)

CPT Procedure Codes:

99050 Office visit, after hours (Note: An exam could have also been billed)

70300 Radiographic examination, teeth; single view

70355 Orthopantogram

21497 Interdental wiring/fixation for condition other than fracture

12011-51 Simple repair of lip laceration, 2.5 cm or less

41899-51 Unlisted dentoalveolar procedure (e.g.,reimplantation of avulsed teeth)

What next?

Call the medical to ask if accidental injury benefits are paid to out-of- of network providers and how long injury-related treatment will be covered following the accident (e.g., 90 days, 12 months, etc.).