Ask the Coder (164)

D9940 is an occlusal guard this procedure will require a brief narrative to prove medical necessity. It is a removable dental appliance and is designed to minimize the effects of bruxism and other occlusal factors. D7880 is an orthotic device which also requires a brief narrative to prove medical necessity, however this device is used (more)

The doctor used D9911 and my insurance Cigna doesn't cover, I've to pay $1000. I was even not aware that insurance doesn't cover it. I'm wondering if the doctor can use D9910 instead which is covered by insurance.

You may use either D0120 or D0180, you will need to check with your carrier for specific guidelines.

Since they are a requirement by some insurance companies on the CMS-1500 form I would say that it is also a good idea to enter them on the UB-04 form, but I cannot find documentation that states that it's a requirement. You might want to check with the insurance carrier to be sure.

The D0140 should only have been sent by the GP, If it was certain the patient needed to RCT. The endo coding for it is not neccassary unless they had to diagnosis if the patient really needed a RCT. But the GP sending the D0140 again at the crown appointment is absolutely unnecessary. Most insurances (more)

The most appropriate CPT code is the unlisted code 21089, this code requires a narriative to accompany the claim.

If the dental carrier is requesting you to bill medical first then you are to bill medical first.

D0274 - bitewings - four radiographic images The vertical bitewing positioning allows an image of up to two molars to be taken, showing part of the periodontal ligaments. The horizontal bitewing positioning allows up to three molars to be viewed with one image. Report D0270 for a single film bitewing, D0272 for two bitewing films, (more)

If the fillings touch then it’s one two surface filling. If they don’t touch/aren’t connected then it’s two one surface fillings. Insurance will typically downgrade it and pay based on a two surface, but you have to always bill what you do.