Ask the Coder (12)

Answers

Views

Question

answer

325

views

What is the best code to use for medical clearance?

asw0929 May 18, 2022 11:24 am

I agree. D9310 would be the correct code for this service. D9310 consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician; A patient encounter with a practitioner whose opinion or advice regarding evaluation and/or management of a specific problem; may be requested by another practitioner or appropriate source. The (more)

asked 3 years ago by

Shannon Taylor

answer

463

views

Could Gluma be considered a resign or only a desensitizer?

Admin November 9, 2021 9:45 am

D1206 Topical application of fluoride varnish D9910 Application of desensitizing medicament D9911 Application of desensitizing resin for cervical and/or root surface, per tooth hope this helps

asked 3 years ago by

Shannon Taylor

answer

183

views

How to code an extraction of only coronal portion without root tips?

kmoney October 25, 2021 1:50 pm

There is a not a CDT code to be used for an extraction of an erupted tooth, that is incomplete. In this case you would use the code D7999 for unspecified oral surgery procedure, by report”. If that code is set to $0.00 be sure to put a dollar amount. You would then bill that (more)

asked 3 years ago by

Shannon Taylor

answer

views

If a patient comes in for an extraction and the tooth was extracted, but it was very close to the sinus floor and they had to be sent to an Oral surgeon for alveoplasty. It was explained to the patient that we would attempt the extraction, but this may be a possibility. The patient agreed. The tooth was extracted, but the alveoplasty had to be done by the Oral Surgeon. Can we bill the patient for the extraction?

Admin August 2, 2017 5:29 am

Yes, the extraction should be billed out by the facility/provider who performed the service.

asked 8 years ago by

Shannon Taylor

answer

views

Our practice does a lot of full mouth fluoride varnish applications for high risk patients every 3 months. We have been trying to get this pre-authorized by our state Medicaid. We have to prove it is medically necessary. Their description of medical necessity is vague. Can you give us some examples you have found that works in this case. Most of these patients are very young and we cannot get x-rays on them.

Admin April 26, 2017 8:39 am

The following article will aide you in determining how to assign medical necessity for patients you believe to be high risk. Please click on the link or copy and paste into your browser: https://www.aapd.org/globalassets/media/policies_guidelines/bp_cariesriskassessment.pdf

asked 8 years ago by

Shannon Taylor

answer

932

views

If we extract a root tip that was left behind by another provider, how would we bill for that? It is a permanent tooth. I know we would use D7111 for primary teeth, but I cannot find a code for that with permanent teeth. D7250 does not apply in our case because the procedure was not surgical. Is D7140 appropriate and if not what is the best code to use?

Admin March 16, 2017 11:22 am

Root tip removal should be coded using D7250 removal of residual tooth roots.

asked 8 years ago by

Shannon Taylor

answer

views

I need to know the correct way of handling failed and/or ongoing procedures and how to bill for them. This has been a debate in our office. If a patient's restoration has failed, whatever the reason, and they have insurance, do you report that to the insurance company? For example, a patient gets an amalgam filling and six months later it needs to be redone. What is the most appropriate course of action, doing an adjustment in house, or filing it to the insurance company and adjusting it off afterwards? Some do not want to file and some do. If it was a self pay patient we would adjust it off and not make them responsible. Our insurance patient's are not responsible either, but is it necessary to report it to the insurance company? Please let us know the most appropriate course of action. Thank you.

Admin December 2, 2016 9:47 am

You always bill any treatment performed to the carrier. If you utilize ICD-10-CM codes on your dental form the amalgam re-do should be covered please look at diagnosis codes K08.5 unsatisfactory restoration of tooth

asked 9 years ago by

Shannon Taylor

answer

views

We have recently employed a pediatric dentist. We are having general dentists, outside of our practice, referring patient's to us for treatment. In these cases, the general dentist have already done the patient's exam/recall. Which code is the most appropriate to use when our pediatric dentist initially examines the patient? We are unsure on whether to use an exam code or a consultation code. Do we code differently if we do the patients treatment or if we cannot do the treatment and have to refer them out ourselves?

Admin June 24, 2016 7:28 am

The most appropriate code for the pediatric dentist to use if the general dentist already used D0120, D0145, or D0150 would be D0160.

asked 9 years ago by

Shannon Taylor

answer

235

views

Can you explain how to appropriately use Z01.20 and Z01.21 as a replacement for V72.2. We do general dentistry. We have used V72.2(dental visit) for all of our visits. This code is straight forward if an dental exam and cleaning are being done. But, the confusing part is for different scenarios when a dental exam and cleaning are not being done. For example, patient presents for sealants only, an operative visit only, an extraction visit only, and stainless steel crowns. In all of these examples the patient is coming back to the office for work that is on their treatment plan, but an exam and cleaning are not being done as it says on the diagnosis code. Would Z01.20 & Z01.21 be appropriate to use in these situations? If not what would be an appropriate ICD 10 diagnosis code to use?

Admin October 2, 2015 12:31 pm

No Z01.20 and Z01.21 are not appropriate for sealants, crowns, post operative visits. You will now code why the patient is there, the cause of the sealant, crown, extraction. Example patient comes in for surgical extraction due to gross caries. The provider will now need to tell you "why" he is doing the procedure and (more)

asked 10 years ago by

Shannon Taylor

answer

views

Our practice has just started to use Silver Diamine Fluoride. Is there a CDT code for this? I have researched it and cannot find anything. Would we use D1208 or D1206 if not? Is it considered a fluoride application or a fluoride varnish?

Admin July 18, 2015 7:07 am

It is considered a varnish and you would use CDT code D1206

asked 10 years ago by

Shannon Taylor

1 2 Next »

Ask the Coder (12)

Corporate Profile

Quick Links

ADCA Legal