I have a patient that has had SRP. He has been on perio maintenance (4910) for a year. If they have improved can they go back to an adult prophy (1110) or do they have to stay at a 4910? I was told once we use 4910 they have to stay with that code.
i was told you should always take only the primary adjustment but was always taught to take the higher amount. which is it?
cdt for antibiotic prophylaxis
CC: NONE
HX: No Change
DX: #K buccal resorption under crown
Eye Protection Used: Yes
Anesthetic: Denti-Care Denti-Freeze topical, 4% Septo c/ epi 1/200,000 x 1.7cc, mental
TX: K core/crown prep ALGINATE IMP FOR TEMP, PRE SCAN UPPER AND LOWER ARCHES WITH TRIOS 3 SCANNER, BITE WITH TRIOS 3 SCANNER, NO CARIES FOUND, BUCCAL INTERNAL/EXTERNAL RESORPTION, TOOTH HAS POOR PROGNOSIS, REMOVED BUCCAL GINGIVA THAT HAD GROWN INTO THE CAVITATION, ETCH, P&B, COMP CORE, FINAL PREP, PACKED COTTON WITH TREXODENT, RINSE, DECIDED TO GO TO THE OS AND PROCEED WITH AN IMPLANT, GLUMA, PERFECT TEMP, CEMENTED W/ FUJI
SHADE: A1 BruxZir
NEXT: OS consult w/ Dr Lopez
DWP: nothing hot to drink, no crunchy, hard, or sticky foods and floss with pulling floss through not up.
Doni R Mallia, DDS
If I send a claim to a primary insurance and they pay a portion and have a contractual adjustment that covers the remaining portion of the balance leaving no patient balance, is it appropriate to send the claim to the patients secondary insurance hoping they’ll pay what the primary adjusted off, or should the claim only be sent to secondary if the patient has a balance?
If I send a claim to a primary insurance and they pay a portion and have a contractual adjustment that covers the remaining portion of the balance leaving no patient balance, is it appropriate to send the claim to the patients secondary insurance hoping they’ll pay what the primary adjusted off, or should the claim only be sent to secondary if the patient has a balance?