CPT^® 21085, Under Prosthesis-Impression and Custom Preparation

The Current Procedural Terminology (CPT^®) code 21085 as maintained by American Medical Association, is a medical procedural code under the range - Prosthesis-Impression and Custom Preparation.

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Summary

The provider fabricates an oral surgical splint to match the patient’s facial contours by taking an impression, or negative imprint, of the patient's face. An oral surgical splint supports a patient’s facial structures in orthognathic reconstruction, or surgical repositioning of the jaws, and in other oral surgeries, such as when the mandible, or lower jaw, has been removed due to trauma or ablative surgery.

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21453 and 21462 during same surgical encounter

May I suggest you use Modifier 59 on 21453, you need to tell them it a separate procedure and you could also include Mod. 51 as a 2nd modifier. Also, make sure you are using the correct ICD10 dx code... [ Read More ]

Somnogard device

[QUOTE="LoftisX4, post: 483639, member: 498916"] E0485 is for a pre-fabricated device, whereas E0486 is for a custom-device. Is your Somnoguard device custom-fabricated from impressions of the patient... [ Read More ]

Somnogard device

E0485 is for a pre-fabricated device, whereas E0486 is for a custom-device. Is your Somnoguard device custom-fabricated from impressions of the patients dentition? I have a related question. Can a pr... [ Read More ]

Somnogard device

Correct, you [U][B]cannot[/B][/U] bill 21085, it is specific to a specialist who designs and manufactures these types of prosthesis. You should bill E0485 for the Somnogard - Oral device/appliance us... [ Read More ]

Somnogard device

We are using CPT code 21085 for the Somnogard device. We order the guards and our physicians shape and fit the appliance . Do you think the description "This code should only be used when physician a... [ Read More ]

Reimbursement for Orthognathic surgery from Tricare authorizations cross coding orthognathic reimbursement tricare

Normally we bill dentally for most of our dental procedures. There are the few medical but set fee schedules help determine the over all out of pocket cost for patients. In billing medical for Orthogn... [ Read More ]

Oral Appliance for Sleep Apnea ent oral appliance osa sleep apnea

Our physician is interested in providing custom oral appliances for the treatment of obstructive sleep apnea. I have found the following codes related to this service. Procedure Codes: D-9941 or L-8... [ Read More ]

Help with Billing for OMS Services

[QUOTE="rai2004575, post: 429797, member: 304988"]Hey All, Tried doing a search, but could not find any information providing a solid answer related to my issue. I need assistance regarding billing ... [ Read More ]

Help with Billing for OMS Services

Hey All, Tried doing a search, but could not find any information providing a solid answer related to my issue. I need assistance regarding billing for Oral/Maxillofacial surgery services to NYS Med... [ Read More ]

Night Guard cpt code

There has been a discussion on whether or not we are using the correct cpt code for a night guard. We take the molds for the guard but send it out to another company who actually makes it. Should we... [ Read More ]

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