How Dental ICD-10 codes are able to tell a story

Telling the story in Dental ICD-10 Codes

 

Not all medical aid schemes require external cause codes: however, correct use of the codes will allow you to “tell the story” and get paid faster, without providing a narrative.

Good use of  external cause codes (how did the injury occur, what was the patient’s activity at the time of the injury, where did the injury occur and what was the patient’s status at the time of the injury).  By using correct coding the dentist can tell an entire story to a medical aid scheme without having to send in a narrative.

Here’s one such scenario:

A 12-year-old boy fell at home in his yard while riding his bike.

When he fell, he landed on a tree root and cut his lower lip.

The patient now presents for evaluation.

What are the ICD-10 codes?

– S01.541A Puncture wound with foreign body of lip, initial encounter

– V18.0xxA Pedal cycle driver injured in non-collision transport accident in non-traffic accident.

– Y92.017 Garden or yard in single family (private) house as place of occurrence for external cause

– Y93.55 Activity, bike riding

– Y99.8 Other external cause status (includes leisure activity)

The dentist is able to tell the medical aid scheme why the patient was treated, how the injury occurred, where the injury occurred, what the patient was doing at the time the injury occurred and why they were doing it (i.e. civilian, military or work related).

 

This is pretty cool and the effort that is put in up front before the claim is submitted is going to prevent lots of headaches and paperwork later on.

 

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