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Facility code for a pediatric patient

  1. #1
    Question Facility code for a pediatric patient
    Medical Coding Books
    We have a patient that came in for a dental procedure in the facility. I need a facility only code for this. It cannot be a ADA code or an anesthesia code. The patient received authorization for facility and anesthesia from the medical insurance for the facility only. This patient also has some mental issues.

    Jenny

  2. #2
    Location
    Madison Area Chapter in Madison WI
    Posts
    113
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    Quote Originally Posted by Jarant View Post
    We have a patient that came in for a dental procedure in the facility. I need a facility only code for this. It cannot be a ADA code or an anesthesia code. The patient received authorization for facility and anesthesia from the medical insurance for the facility only. This patient also has some mental issues.

    Jenny
    Have you looked at the HCPCS codes? Depending on the procedure performed, you should be able to find an appropriate HCPCS code. They are in the D section of the HCPCS manual. These are not ADA codes although the ADA uses the same codes. Otherwise, are there any CPT codes that accurately reflect the procedure performed?
    Happy Coding, Claudia


    Claudia Yoakum-Watson, CPC
    Coding, Compliance, & Reimbursement Solutions
    [email]ccrsconsulting@tds.net
    ccrsconsulting.com - website

  3. #3
    Location
    ENGLEWOOD/DENVER
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    2,338
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    Assuming that this is an ASC facility that you are speaking of since this is the ASC forum....unfortunately we can not use the D codes and must use the 41899 since this is filed under the patients major medical carrier and not a dental policy (at least this is what I remember when I was actually employed at at ASC). I do still code for several ASC's and this is the code that we use for reimbursement.

    Hope this helps
    Mary

  4. #4
    Smile
    Thanks!! I will try the 41899 code.

    Jenny

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