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  2. Medical billing in dentistry

Frenectomy (frenotomy, frenumectomy, frenulectomy)

CPT Codes for billing frenectomies to medical insurance

Billing frenectomy to medical insurance:

Procedure codes:

  • 41010 - Incision of lingual frenum (frenotomy)
  • 41115 - Excision of lingual frenum (frenectomy)
  • 40806 - Incision of labial frenum (frenotomy)
  • 40819 - Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)

**Note: we generally only see 41010 & 41115 as covered if patient meets criteria in medical policies we see for this.

Diagnosis codes:

  • Q38.1 – Ankyloglossia

For feeding difficulties:

  • R63.3 - Feeding difficulties
  • P92.5 - Neonatal difficulty in feeding at breast
  • P92.8 - Other feeding problems of newborn
  • P92.9 - Feeding problem of newborn, unspecified

For childhood articulation problems:

  • F80.0 - Phonological disorder
  • F80.89 - Other developmental disorders of speech and language
  • F80.9 - Developmental disorder of speech and language, unspecified

Here is a link to Aetna’s medical policy titled “Frenectomy or Frenotomy for Ankyloglossia” for an example of the coverage criteria:

http://www.aetna.com/cpb/medical/data/100_199/0116.html

Aetna’s policy states “Aetna considers inferior lingual frenectomy or lingual frenotomy for ankyloglossia medically necessary when newborn feeding difficulties or childhood articulation problems exist.”