Ask the Coder (163)

Hello adcaonline.org webmaster, Thanks for the well-structured and well-presented post!

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)

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

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!!

D0171

Hello! This is a great question. For D4910, each insurance plan is different. If the patient has coverage for D4910, typically, the insurance will want the date of the initial scaling and root planing along with x-rays and perio charting less than 12 months old. When it comes to the perio maintenance frequency, that also (more)

Hello! D9222 and D9223 are billed specifically in 15 minute increments, so if it is under 30 minutes, it is not recommended to bill for both D9222 and D9223 (total of 30 minutes) if only 20 minutes of sedation were performed.

Well truly, medical should be billed first. Also, the answer is going to depend on if the service is covered under the patient's medical plan. Since it's a pano or bitewing... it's likely that it will not be covered medically. If it is... be sure that you have a good medical diagnosis to support the (more)

katana