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I am new to dental coding and having a hard time deciphering exam code D0150 from D0140 for new patients. To provide an example, I had a patient who came to the oral surgeon on referral from her regular dentist to have her wisdom teeth removed. The oral surgeon notes in the history that her wisdom teeth are impacted but asymptomatic, that she has no allergies, her family history is non-contributory, and she's not a smoker. He then takes a panorex and looks at the gums and notes the impacted wisdom teeth and the absence of any malocclusion. He is not including a total perio chart in the record (though he's also indicated the presence of a malpositioned canine tooth). He doesn't mention the hard/soft palates or any soft tissue anomalies (not referencing looking at the tongue or the mucosa). So while he is looking around at a lot of structures in the mouth, not just at the wisdom teeth, he doesn't appear to me to be documenting the full extent of what is described by CDT code D0150, but at the same time, D0140 for a problem-focused exam seems like less than the work he is doing. In this particular example, would you recommend D0150 or D0140?

Admin January 4, 2017 8:45 pm

D0140 is for a patient being seen for a specific problem minimal documentation is required. Why the patient was there or Chief Complaint and proposed treatment. D0150 is for a first time patient and must meet the following criteria oral cancer screening, evaluation and recording of patients dental and medical history and overall general health (more)

asked 9 years ago by

ADCA Admin

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Is there a guideline for a dental provider on signing off on documentation when patient is seen? If patient is seen mutiple days, Can one documentation be used or does each day need to be initialed and/or signed by the dentist?

Admin December 28, 2016 11:16 am

No, the provider must document clearly each day what was done and each day needs to be signed off on.

asked 9 years ago by

ADCA Admin

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Our office took a panorex xray for a patient for purposes of teeth extraction at the oral surgeon. The patient wants me to send the Panorex xray claim to medical insurance since it is related. What code do I use for the Panorex and what would be the diagnosis code I put on the 1500 form?

Admin December 16, 2016 8:46 am

70355 the diagnosis code would depend on the findings example why are the extractions being performed...impacted teeth, decay, etc.

asked 9 years ago by

ADCA Admin

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can insurance companies create their own billing for FMX? the CDT books says usually consist of 14-22 PA's and BW's but I'm being told by the dental biller that some insurances want the FMX code when less than 14 x rays are done. I would like clarification if this is ever appropriate to do. thanks.

Admin January 1, 1970 12:00 am

Coding guidelines state 14-22 periapical films including bitewings must be present however, some insurance companies are paying out an FMX when a pano and bitewings are taken. The best course of action is to appeal the claim stating 14-22 films were not present at this visit.

asked 9 years ago by

Rena Yazzie

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how do I sign up for the CDC exam

Admin December 3, 2016 4:11 pm

Go to the website and click Certification - CDC

asked 9 years ago by

ADCA Admin

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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

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wondering if there is a dental chart audit form available to print or download? or maybe direct me to a site or organization that might have one.

Admin December 1, 2016 11:19 am

Unfortunately there is no dental chart audit form available that we are aware of at this time.

asked 9 years ago by

Rena Yazzie

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(Once you purchase the exam it will be released within 2 business days of purchase.)How will I know that the exam has been released for me to take?

Admin November 27, 2016 8:55 pm

Once you have been approved to take the exam you will receive an email with the URL along with your username and password. Please note some individuals will undergo an audit prior to the release of the exam these individuals will be notified by mail. The address used will be the one in your members (more)

asked 9 years ago by

ADCA Admin

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how many CEUS do I need to renew membership?

Admin November 15, 2016 3:49 pm

depending on how many credentials you hold it is 12 CE's for the first credential and an additional 4 CE's for every credential you hold in addition.

asked 9 years ago by

ADCA Admin

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I would like to know if a scaling and root planning has been done on only 1 or 2 teeth on the right upper quad are we required to still do periodontal maintenance on the entire mouth and bill for that. Is it possible to bill for only those two teeth for periodontal maintenance and then a regular prophy for the rest of the mouth?

Admin November 9, 2016 9:07 am

RSP must be done on a separate visit. It is not billable in conjunction with periodontal maintenance or a prophy.