Ask the Coder (539)

D6199 or D0393 depending on the carrier

1 & 3. The impression is inclusive of the appliance however, some insurance carriers will allow D0470 2 & 4. Depends on the appliance 21243, 21085, 21089 ??? 5 &7. D0470 6 & 8. 99002

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

The following providers may bill CDT code 0190 MD, NP, RN, and Hygienist.

The standard is 13 years and older

Since this was a restorative material failure and it was composite and codes only exist for crown, inlay, onlay, and veneer the most appropriate code would be D2999 with a brief narrative to accompany the claim.

It is not common practice to code D0120 with treatment, this is used for 6 month check-up. You are to use D0140 or D0170 for exams with treatment as long as the documentation supports an exam at the same time.

For medical it is usually billed out in 15 minute increments, for dental according to utilization review guidelines this code is to be used once per visit.

You will use the NPI of the dentist who performed the work in box 54 and the facility/dentist (sole proprietor LLC information) entity in boxes 48-52

CEU's may be submitted starting June 1st of each perspective year...you must sign into your members dashboard and select the "upload CEU" button.