Ask the Coder (165)

The doctor used D9911 and my insurance Cigna doesn't cover, I've to pay $1000. I was even not aware that insurance doesn't cover it. I'm wondering if the doctor can use D9910 instead which is covered by insurance.

You may use either D0120 or D0180, you will need to check with your carrier for specific guidelines.

Since they are a requirement by some insurance companies on the CMS-1500 form I would say that it is also a good idea to enter them on the UB-04 form, but I cannot find documentation that states that it's a requirement. You might want to check with the insurance carrier to be sure.

The D0140 should only have been sent by the GP, If it was certain the patient needed to RCT. The endo coding for it is not neccassary unless they had to diagnosis if the patient really needed a RCT. But the GP sending the D0140 again at the crown appointment is absolutely unnecessary. Most insurances (more)

The most appropriate CPT code is the unlisted code 21089, this code requires a narriative to accompany the claim.

If the dental carrier is requesting you to bill medical first then you are to bill medical first.

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)

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

Since the patient had 4 quads of SRP, the patient is a PM at that point. Just as an FYI, the first PM appointment is usually 90 days post SRP. So, for example, Delta is denying our D4910's within 90 days of SRP. This is a WRITE OFF. Not billable. Since it was NOT past (more)

There is no code specific to just reattaching the locator abutment. I would say that you should bill D6199 and include documentation reporting what was completed.