Oral Surgery Coding & Reimbursement Alert

Question: Our surgeon recently placed miniscrews (temporary anchorage device) for providing anchorage during orthodontic treatment. Since it involves placing a screw (although temporarily), I am wondering if we should use the CPT® code for placement of implants for reporting this procedure that our surgeon performed.

Illinois Subscriber

Answer: Even though your surgeon placed miniscrews into the jaw bone, you should not report this with placement of implant codes (21248, Reconstruction of mandible or maxilla, endosteal implant [e.g., blade, cylinder] partial or 21249, …complete). You should use implant placement codes only when your surgeon places an implant into the jaw bones for replacement of missing teeth.

Your surgeon will place temporary anchorage devices (TADs) or miniscrews into the bone to provide anchorage for movement of teeth. The usage of TADs will prevent movement of molar teeth into extraction spaces thus allowing required movement of the anterior teeth.

When your surgeon places miniscrews into the bone to provide anchorage and to help in traction, you will have to report this with the CPT® code, 20650 (Insertion of wire or pin with application of skeletal traction, including removal [separate procedure]).