Ask the Coder (546)

What is the secondary changed their fees/policy? If 100 allowed, primary paid 80, then I would transfer the $20 to the secondary, let the secondary adjudicate then make my adjustments. I am not saying balance bill. The primary allowed 100, I would transfer up to that just like EOB says to secondary. You could be (more)

Agree with prior post, dentist do not usually charge a lab fee. BE careful charging more than the allowed amount on contracted plans and covered services; that is a compliance no no.

D0171

The claim should be submitted to secondary insurance even if there is a remaining balance. It's crucial to ensure that the patient's primary and secondary insurance records accurately reflect their procedure history.

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!!

This is considered the same as a diagnostic. Therefore, the appropriate code would be D0470

I think yes he can charge you. D9310 is consultaion- diagnostic service provided by dentist or physician other than requesting dentist or physician. It means a patient encounter with a practitioner whose option or advice regarding evaluation and or management of a specific problem may be requested by another practitioner. The consultation includes an oral (more)

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.