Ask the Coder (537)

Well truly, medical should be billed first. Also, the answer is going to depend on if the service is covered under the patient's medical plan. Since it's a pano or bitewing... it's likely that it will not be covered medically. If it is... be sure that you have a good medical diagnosis to support the (more)

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)

You can certainly charge out radiographs with restorations. You have to be mindful of the plan limitations set in place by the carrier. If a patient has had a full mouth series done within a specified time limit the bitewings and pa’s may not be covered because the patient has exceeded their limit. There are (more)

When you say "drugs" be more specific. Are you referring to other sedative medications? I cannot see why other medications would not be covered because moderation sedation was used. This may also be payer specific and/or plan specific. You might also want to document the reason for needing any additional medications (ie: patient was autistic (more)

Unfortunately, I can't exactly explain why a payor would request a tooth surface, but it may be a requirement of the plan for the code. This is probably given to be sure that duplicates are not billed. Also, they are typically subject to a 5–10-year limitation. There can be quite a few limitations to these (more)

Virginia will pay for dentures for adults. It does have to be pre-authorized. Most of the time they are approved.

Thank you for your answers. I am still confused. Could I use code D5640 Replace broken teeth? even if the teeth are not broken? they are just worn out. please help clarify

D5640

Yes, these codes may be used together.

D9310 should only be used on the initial examination where a referral was requested. If continued examinations are performed the appropriate code selection would be D0140.