Wiki FQHC Dental Question

NClemons

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This is my first time working for an FQHC. My question is FQHC and dental specific. Our providers have been using Z98.810 (Dental sealant status ) as the diagnosis when applying sealant. It's my understanding that status codes can not be a principal diagnosis. BUT... if (D1351) sealant is considered a prophylaxis or preventive treatment measure there is no definitive diagnosis. ie.. caries, erosion of tooth, etc... because it's applied before any caries develops. So what can the provider's use as a principal diagnosis? Can it be part of the Z01.20 (Encounter for dental examination and cleaning without abnormal findings )code even if it is provided on a separate DOS and cleaning was done prior? Or what diagnosis is an acceptable principal diagnosis. Thank you!
 
Hello, was wondering if anyone can answer the above question. I am new to dental coding and have the same question. Thank you!
 
I don't think it would make sense to use Z01.20 if the dental exam and cleaning were not done on the same day as the application of dental sealants. There are a few other ICD-10 CM codes that might be appropriate for this scenario.

Per Encoder Pro:
Range Z91.841-Z91.849-Dental caries, or tooth decay, is breakdown or demineralization of the tooth enamel caused by acids produced by bacteria, particularly Streptococcus mutans. This subcategory was created to classify a patient's personal risk of developing dental caries with three severity levels: low, moderate, and high. These risk levels assist dental providers with identifying etiological factors, determining treatment modalities, clinical data collection, and monitoring and research. Risk management can reduce patient risk of developing advanced disease or arrest the disease process. Primary prevention measures include fluoride therapy, fissure-sealant therapy, dietary counseling, and oral-hygiene measures.

Z91.841-Risk for dental caries, low
Z91.842-Risk for dental caries, moderate
Z91.843-Risk for dental caries, high
Z91.849-Unspecified risk for dental caries

There is also code Z13.84-Encounter for screening for dental disorders.
 
we are using the below codes in such scenarios.
Z91.841-Risk for dental caries, low
Z91.842-Risk for dental caries, moderate
Z91.843-Risk for dental caries, high
Z91.849-Unspecified risk for dental caries
 
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