Ask the Coder (539)

Should D0251 be used twice to indicate both left and right?

It was removed jan 2023 if I am not mistaken.

Legally, you must bill out for the procedures that were performed by the provider and the charges billed must match the clinical notes.

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!!

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)

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.

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)

Hello! This depends on whether or not the primary plan will even coordinate benefits with a secondary plan. Typically, Aflac and Colonial Life are fee schedule plans where the patient pays the difference between their fee schedule contract fee and UCR. Some Colonial Life or Aflac plans directly reimburse the patient and not the office, (more)

9310 is the correct code. Consultations (D9310) and exams often share the same frequency, by any chance was the D9310 denied due to frequency for exams had been met? Also, many dental plans will consider the exam inclusive of any other treatment performed that day and it might have been denied due to payment processing (more)

Suture Removal would only be charged for if your provider did not place them. Otherwise, they are included in the procedure that required them.