ED Coding and Reimbursement Alert

Question: A patient reported to the ED at 8 a.m. on a Sunday morning. He described a horrible toothache that started on Friday, but the pain was too severe to wait for the dental office to open Monday. He reported 10 on a 10-point pain scale. The ED physician performed what he documented as an “inf. Aveo block,” according to the notes. Which condition do the notes reflect, and how should I code this scenario?

Codify Subscriber

Answer: You should double-check with the physician before filing the claim, but the shorthand appears to indicate that he performed an inferior Alveolar block, which is a type of dental block. If the physician confirms this procedure, report the following:

• 64400 (Injection, anesthetic agent; trigeminal nerve, any division or branch) for the block
• K08.9 (Disorder of teeth and supporting structures, unspecified) appended to 64400 to represent the patient’s condition.