Admin – Answers

June 25, 2026 by Admin

Votes	Status	Answer
0 votes	approved	Rule of thumb is to use the primary carriers fees to set the adjustment level.... posted March 24, 2015 7:30 am in reply to I am new at dental billing. I am trying to figure out how to post primary and secondary insurance payments but me predecessor didn't always post it the same way so I can't figure it out that way. In medical billing you take the insurance adjustment from the primary insurance and not the secondary insurance. When I tried to google how to apply the primary and secondary insurance payments I got various, conflicting answers. So my question is how am I supposed to post primary and secondary payments? Which adjustment am I supposed to use?
0 votes	approved	You may code 00170 for the sedation and still use D9230 for the nitrous oxide to the medical carrie... posted March 12, 2015 4:02 am in reply to Our client owns a pediatric dental clinic. The code that my client uses on a maximum basis is 9248 in conjunction with 9230. The total UCR for these is 295 and 55 respectively. They are mostly used together. So this puts my client in a situation that if they are covered, then he gets paid less, because usually the parent would pay out of pocket for these, and the whole procedure would make sense. Now with such a low fee, it does not make sense considering the stress involved. Is there any alternative way/ code(s) to charge for non-intravenous sedation using inhalation of Nitrous Oxide. Is there any scope of charging, using ASA (CPT) codes if the patient also has medical insurance coverage apart from dental coverage?
0 votes	approved	Usually there is a slight difference is the amount paid; this is carrier driven so it is best to che... posted March 12, 2015 3:52 am in reply to My concern is regarding the sedation codes used for dental anesthesia as - D9220. D9221, D9230, D9241, D9242 and D9248. If the provider is credentialed as a specialist, will there be a difference in the amount paid and allowed by the insurance companies?
1 vote	approved	Without specific information the most common code usage for an endosteal implant would be dental cod... posted March 6, 2015 1:48 pm in reply to what code do u use for implant
-2 votes	approved	Without knowing the specifics, yes, D5863 is the correct code for overdenture- complete mandibular r... posted March 6, 2015 12:39 pm in reply to We use code D5865 for a complete mandibular overdenture, but it only pays about $1000. Our cost is about $4000. Is there a different code we are supposed to use or is there an additional code that I should use?
0 votes	approved	The most appropriate codes for your scenario are as follows: D0220, D0230, D4921... posted March 5, 2015 10:28 am in reply to Please advise coding on the following: Pt. presents with pain, swelling around #3--took 2 PAs and measured pocket depths in area--sulcus of #3 gushed pus and blood when probed--doctor treated as perio abscess by doing gross debridement to let it drain through the sulcus, irrigated with Chlorhexidine and prescribed antibiotics.
0 votes	approved	Without specifics(how big is the laceration, was a limited exam performed) the following codes are t... posted March 4, 2015 10:24 am in reply to How would you code for the following: an 8-year-old presents with lacerated lip--IM injection of Ketamine for sedation--debridement of the wound with 2 sutures placed
0 votes	approved	ICD-9-CM code 520.8... posted March 4, 2015 10:22 am in reply to How do I code for a super-erupted tooth #15?
-2 votes	approved	Without specific information as to whether this was a repair or initial placement the most appropria... posted March 5, 2015 10:20 am in reply to How do you code for the cast metal parts of a Maryland bridge that are bonded to the lingual of the adjacent teeth?
0 votes	approved	Without specific information (custom or prefab, made in office or outside lab) the most appropriate ... posted March 4, 2015 10:18 am in reply to Need code for an abutment-supported connecting bar with Hader and ERA attachments, please.

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