Ask the Coder (165)

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.

D0274 - bitewings - four radiographic images The vertical bitewing positioning allows an image of up to two molars to be taken, showing part of the periodontal ligaments. The horizontal bitewing positioning allows up to three molars to be viewed with one image. Report D0270 for a single film bitewing, D0272 for two bitewing films, (more)

If the fillings touch then it’s one two surface filling. If they don’t touch/aren’t connected then it’s two one surface fillings. Insurance will typically downgrade it and pay based on a two surface, but you have to always bill what you do.

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)

D2980 crown repair necessitated by restorative material failure A repair to a crown because the material used to make the crown cracked, chipped or broke.

D2950 should be bill the day it is rendered to avoid denial for inclusive reasons, and you should always bill for what you do on the DOS. D2950 is considered a stand alone code, and is commonly denied for inclusive procedure when coded with a crown code on the same DOS without a seat date. (more)

D9999 is an unspecified Oral Surgery procedure, in this case even though the dentist was not the person to do the extraction, but he did do the removal of the stitches. I believe even if it’s not billed code d7912, it is the proper code for the procedure the patient had.