Ask the Coder (532)

Spacers are not billable procedures they are considered inclusive of another procedure. Usually space maintainers or orthodontia services.

By spacer band we are assuming you are referring to a space maintainer? Is that correct? If so you would use CDT codes D1510-D1525; Depending on if the space maintainer is fixed or removable.

The most accurate code would be CDT D7998

Since there is no current code listed for zirconia crowns depending on the carrier they will request CDT code D2999 and a narrative as to the "medical necessity" of this material rather than a standard crown. Some carriers will allow CDT code D2783, however, you will need to check with your carriers utilization review guidelines (more)

No! Whatever procedure the doctor performs must be within his contratual guidelines. Meaning if he charges the patient an extra fee he must report that fee to the carrier, otherwise, this maybe considered a form of fraud.

No, according to carrier guidelines and utilization review standards the lab fee is considered inclusive of the procedure. Meaning you may not charge a seperate fee for the lab.

You may not collect more than your usual and customary fee. So to answer your question, no, you would not bill a secondary claim if the primary insurance paid in full and there is no patient portion.

No it is not considered bilateral...however you would have two codes one for the maxillary and one for the mandibular. If the jaw sugery was performed on both upper and lower, right and left sides then you would have a bilateral upper and lower jaw surgery.

The most common code used for this procedure is D7283. If you surgically exposed the tooth you would use D7280 in conjunction with D7283.

You should bill whatever is documented in the chart...documentation is the supporting foundation for codes. If it is not documented you may not bill for services.