Admin – Answers

June 25, 2026 by Admin

Votes	Status	Answer
0 votes	approved	Please visit our forms section in your members dashboard for a generic template on medical necessity... posted April 14, 2011 5:46 am in reply to I have two claims for crowns that have been denied - two separate patients, one insured with MetLife, the other Principal. I have been through one appeal with MetLife and two appeals with Principal. I have never had claims denied for lack of necessity. They were necessary and obviously I did not provide the correct documentation/narrative. I would appreciate any help getting insurance benefits for these two patients. Thank you, Beverly Knight
0 votes	approved	Therapeutic drug injections are coded to medical carriers by the actual drug being used. If the drug... posted April 5, 2011 5:16 pm in reply to I need help with coding for a therapeutic drug injection, I was told to use CPT 96374, however this keeps being rejected as apart of the global code for my anesthesia 00170; where on my CMS-1500 do i specify what kind of drug this is so that it will be paid? I have found J code J1100 for decadron but do not know where on the claim form it should be listed. Thanks
-1 votes	approved	Depending on the device, if you are using TAP appliance you would use 21089 for the appliance and 99... posted March 24, 2011 1:37 pm in reply to How would you bill for a sleep apnea device to be used in conjunction with a CPAP machine to medicare? I have been using a 1500 form using dx: 327.23, 780.57,& 286.09. New office visit 99203 & E0486. With a description of the E0486. Should both of these codes be payable by Medicare and/or commercial insurance payers? Or am I billing this incorrectly?
0 votes	approved	1) Tapp appliance 21089 for appliance and 99002 for handeling must have a narrative accompany claim.... posted March 23, 2011 8:53 am in reply to Need the following medical codes & descriptions and any narratives that may apply:1) Tapp applicance reguarding sleep apnea not a CPAP appliance2) Code for a pt that fell & broke her bridge3) Pano or full mouth x-ray4) TMJ5) Visolite (oral cancer screening)6) Exam for injury7) Pa ( single x-ray)8) Sedation (oral)9) Nitrous Oxide10) Frenulectomy11) GingivectomyReceipt No: 0060-3277-6206-5138Gina
1 vote	approved	... posted March 17, 2011 4:32 pm in reply to need medical codes for our dental office, can someone call me or do I need to call you?
-1 votes	approved	Typically they are answered within 72 hours depending on the level of difficulty of the question bei... posted March 10, 2011 9:20 am in reply to I am starting a new job in dental billing. I am certain I will have billing and coding questions to submit. How fast, generally, will I receive an answer to my question?
1 vote	approved	There are over 50,000 diagnosis codes in the ICD-9-CM book, you must utilize the code that best desc... posted February 23, 2011 12:32 pm in reply to What is the diagnostic medical code I should use when billing a medical carrier?
0 votes	approved	The most appropriate CPT code is the unlisted code 21089, this code requires a narriative to accompa... posted February 12, 2011 9:07 am in reply to Is there a CPT code for an occlusal guard? (D9940 CDT)
1 vote	approved	The appropriate code to utilize with a patient that has a diagnosis of periocoronitis and has the pe... posted February 11, 2011 1:00 pm in reply to If a patient has periocoronitis on tooth 17 and the dentist burns the flap of skin off, what is the correct code? I say D7971, but the dentist insists that I code it under D7280, since operculectomy is not covered under the patient's insurance (Florida Medicaid). The dentist did not remove any bone, did not make an incision. Who is right?
0 votes	approved	No, dental carriers do not require the use of diagnosis codes when processing claims.... posted January 17, 2011 7:18 am in reply to Do dental insurances accept ICD-9 diagnosis codes when processing claims?

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