American Dental Coders Association

Dental Billing & Coding Training

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    109
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    At what age do you charge adult prophy instead of child prophy?
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    Can you use a D0145 then chg a D0120 and then a D0150 when they turn 3 yrs old

    We are seeing children under 3 for sometimes 3 appts and then charging out a D0150 . Wondering if we can chg a D0120 for a visit and then a D0150

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    What area/tooth should be reported when billing d1517?

    Extraction of primary tooth #t was done and impression for space maintainer will be done at next visit.

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    15
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    What is the appropriate code for removal of a mandibular tori fragment?

    Patient was administered anesthetic, gum tissue was opened, & a burr was used to grind off a piece of tori that was protruding from LR lingual area.

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    I noticed one of the publications mentioned on the ADCA website is Oral Maxillofacial coding/billing book published by PMIC. I wondered if you have any experience with this book and if this is beneficial for the dental coder in Oral Maxillofacial surgery? Thank you! Lynette Kardell, CPC,CDC
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    12
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    Is there an age when Medicare is automatically the primary insurance carrier in the state of Massachusetts?
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    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?
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    Filing a medical claim. CPT 21040 ICD-9 526.0, the doctor grafted the defect using code 21215. I am not sure what modifier to use, he also did this procedure under IV anesthesia 3 units of 00190.
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    When would you expect to see the D7951--sinus augmentation with bone or bonesubstitues code used?The procedure in question is: Placement of implant at site #3 with possibleindirect or direct sinus lifting.The Oral Surgeon documents that an "indirect sinus lift" was performed. Thank you. Brenda
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    Do dental insurances accept ICD-9 diagnosis codes when processing claims?
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      American Dental Coders Association
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      Peoria, AZ 85382
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