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If I send a claim to a primary insurance and they pay a portion and have a contractual adjustment that covers the remaining portion of the balance leaving no patient balance, is it appropriate to send the claim to the patients secondary insurance hop...
Anonymous April 8, 2025
Hello! The patient's secondary insurance always needs to be billed to ensure accurate procedure history, regardless of the amount of the primary insurance's payment. Hope this helps!!
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d0470 diagnostic casts, what code is for the wax up
Anonymous August 19, 2024
This is considered the same as a diagnostic. Therefore, the appropriate code would be D0470
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My dentist referred me to another dentist at another company for procedure D3348. After the procedure, I was billed D9310 in addition to D3348. I personally did not need a consultation and only required D3348. Do I have to pay this invoice and if not...
Anonymous June 29, 2024
I think yes he can charge you. D9310 is consultaion- diagnostic service provided by dentist or physician other than requesting dentist or physician. It means a patient encounter with a practitioner whose option or advice regarding evaluation and or management of a specific problem may be requested by another practitioner. The consultation includes an oral (more)
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If 2 bitewing images was taken on a pano machine (where the image is split done the middle to create bitewing image) what is the appropriate code? D0272 or D0251?
Anonymous March 18, 2025
Should D0251 be used twice to indicate both left and right?
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I am unsure when the CDC-M05 was updated, but the newest edition removed 99201.
Anonymous April 8, 2025
It was removed jan 2023 if I am not mistaken.
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HI I submitted a prior auth for D2392 and D2929 for several teeth and req to please allow for alt benefit for D2930 and downgrade to amal fee. I received the preauth back with only coverage on D2331 on #R . Can I legally submit a D2930 with our fee f...
Anonymous April 8, 2025
Legally, you must bill out for the procedures that were performed by the provider and the charges billed must match the clinical notes.
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Pt presents for cleaning, not due for periodic exam or xrays, but has a question about a tooth so a PA is taken and Dr evaluates. I would typically bill out a periodic with the pa and prophy however it was brought up that D0140 may be applicable.
Anonymous April 17, 2024
You need to check your insurance contract and fee schedule limitations for that particular insurance. Typically, insurance will not cover a D0140 and D1110 the same day but it depends on the contract. Hope this helps!!
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The Oral Surgeon Charged me $2,500.00 when I made the Appointment and I have to pay another $2,500.00 before I have the Proceedure. There was No Dental code Provided.
Anonymous March 26, 2024
Your question is subjective and depends on the charges and members allowable by the patient's insurance company, depending on the Oral Surgeon's participation in Dental and Medical plan coverage and procedures that will be performed based on medical necessity. In this instance, the Dental code would be D0704 &Imaging & D0470 records. The Medical would (more)
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When billing D0251, should we bill 1 or 2 units of this because it's both the right and left side? And does it matter if it's for primary or permanent teeth?
Anonymous April 8, 2025
Extraoral images are captured when the image receptor is placed outside the patient’s mouth, such as a CBCT or panoramic X-ray. For D0251, you will bill one unit since it is categorized as an image of the entire posterior dental region. This code can be billed for both primary and permanent teeth.
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Can you use only D0150 for comp exam for a child under 3 or do you have to use D0145?
Anonymous February 19, 2024
There are several different ways to handle this. I am assuming this is a new patient to your practice, you can bill out a D0150 as long a comprehensive exam is completed with the normal gathering of medical/dental and general history. Or you could also bill a D0145 before the age of three if counseling (more)
