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    When billing for implants, do you include the abudment placement as part of D6010, or do you bill the abudment separately when it is placed D6057?
    October 28, 2014 2:13 pm
    Billing for implants is the same as billing for a crown or bridge. Without seeing the providers notes if a single crown is supported by an abutment you may consider using D6058-D6094 instead.
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    Is there a specific ADA code for a diagnostic wax up?
    October 21, 2014 1:26 pm
    This is considered the same as a diagnostic casts(study models, diagnostic models), in essence it is a working mold. Therefore, the appropriate code would be D0470
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    Are there any good reference materials you could suggest for helping answer questions pertaining to billing of implants and abudments, bone grafting, materials used for bone grafting and implants?
    October 16, 2014 7:47 am
    The ADCA is coming out with an Oral Surgery specific course that will assist with coding and billing dental implants. This course is set to be released January 20, 2015. In the meantime you may check with Glidewell Dental Lab as they offer a course on billing dental implants.
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    When billing for TMJ splints, can you bill them on the order date, or do you have to bill them when dispensed to the patient.
    October 16, 2014 7:45 am
    This is carrier specific and you will need to check with each individual carrier guidelines. However according to Delta Dental Utilization Review the rule of thumb is to bill on the delivery date.
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    For bone grafting for the purpose of implant placement, our oral surgeon uses a couple different types of material for the grafting, a membrane. To code this and bill to insurance, I am using D6104, D4265 and D4266 for billing. Is this correct or should all charges be simply billed under only the D6104?
    October 16, 2014 7:04 am
    The only code that should be billed for the service you described above would be D6104.
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    I have a question. I have providers in my peds specialty that want to bill a D1206 Varnish with a regular preventive exam. Can they with the D code? And/or is there a comparable code in CPT?, And would they be reimbursed for it? and what are the RVUs associated with this code?? Thank you so much, cheers, Emily Heed CPC, CDC-A
    September 27, 2014 12:04 pm
    Yes they may bill the D code to medical as there is no compatiable CPT code for fluoride varnish. As for reimbursment of this procedure to medical providers there is no statistical data to prove one way or the other as of yet. It is completely upto the individual carriers.
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    I work at a hospital based dental clinic which also has a dental residency program. We are switching from the hospital billing system to Softdent on Monday September 15. During training it came to our attention that the claim forms are generated from the schedule in Softdent. Our current procedure for claims is that all the residents and hygienists are billed under our program director and claims are sent out under his NPI # and license #. With the way Softdent is set up we can have a "billing provider" and a "treating provider". Our problem is that the residents do not have license numbers but they do have NPI numbers. The hygienists have license numbers but no NPI numbers. The ADA claim form has those fields under the treating provider section. Is it ok to have the resident/hygienist listed on the claim form without having a license number or NPI? I hope you can help us solve this problem as we are going live with the new software on Monday. Thank you for your time and assistance.
    September 11, 2014 1:49 pm
    The appropriate way to submit the claim would be to have the attending provider’s information in box 45-52a and the treating/resident/hygienist information placed in box 53-58 of the ADA 2012 claim form. You may submit the claim with the hygienist or residents NPI number only as long as the attending has both NPI and license (more)
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    Could you help me with the medical claim coding for custom fluoride trays for a patient that had treatment for oral cancer? The radiation causes a decrease in saliva production, resulting in a dry mouth-which leads to an increase in tooth decay. So, the fluoride trays are a preventative measure against tooth decay. I need the medical billing codes (not the dental, as his dental insurance will not pay for the trays.) Thank you!
    September 10, 2014 3:24 pm
    You would need to code the appropriate oral cancer code (170.1, 198.5, ect) as the initial diagnosis and Xerostomia (527.7) as the secondary diagnosis. Since fluoride trays are not typically a covered procedure under medical and there is no specific code the most appropriate procedure or CPT code would be 21089. This code will need (more)
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    Hi Can you tell me how many CEU to maintain for active membership? thanksCindy
    September 5, 2014 12:29 pm
    The association requires 12 CE's per year...these CEU's must be uploaded to your members dashboard under the submit CEU's tab before December 31st of each year.
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    Where do I look to find the numbers of CE's I have.
    August 28, 2014 8:39 am
    Your CEU information will be located in your members dashboard under submit CEU"s.
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