Ask the Coder (537)

HCPCS code for versed is J2250. It is placed in boc 24D of the CMS-1500 form.

For a child under 3 years of age you should use D0145, for children over the age of 3 you should use D0150

No, D0150 and D0180 may not be coded in the same visit. No, a hygienist may not code D0180 or any other exam it is not within their scope of practice. Exam codes are to be billed by a denist only. The only exception would be for an affiliated dental hygienist to bill for D0190-D0191 (more)

The most appropriate code would be D7971 (excision of pericornal gingiva)

The correct ICD-9-CM code for tobacco user, active smoker is 305.1

Usually dental carriers will only allow flouride varnish to be paid to a dentist. However, we have seen some instances where a medical provider was paid for it during a preventative visit. It is up to carrier discretion, you should always check with the specific carrier prior to work.

There is no medical code for D1206 (topical application of fluoride varnish) or D1208 (topical application of fluoride) as this is not a covered medical expense. Depending on the documentation provided an appropriate crosscode for D0145 (exam child under 3 years) would be 99201-99202 for new patient and 99212-99213 for estabilished patient.

You may purchase a book through the National Dental Advisory Service called Comprehensive Fee Report. There website is www.ndas.com

You will charge out for a new crown and provide a narrative with the claim explaining the circumstances. They will usually pay 50% of the original fee.