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We are having trouble getting our pano(D0330) and bite wing(D0272 or D0274)paid when they are performed on the same day of service. If we took Pano, BWs and additional PA's can we code as FMX? Is there any other way of coding these services in order to receive payment? Thanks
Admin September 22, 2011 8:11 am
A full mouth series usually consists of 14-22 periapical and posterior bitewing images that are intended to display the crowns and roots of all the teeth. Since a panoramic film is not intraoral it would not be appropriate to code this as a full mouth series. You will need to seperate out the codes, if (more)
Admin
asked 14 years ago by
ADCA Admin
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64
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My PT is getting a conventional overdenture. In order to prepare the remaining natural tooth structure to rest under the denture, the doctor must file away the natural tooth crown so only the tooth root remains. Then he must cap the root with composite material. He called the procedure a "root cap." What are the proper CDT codes to use for insurance billing purposes?
Admin September 21, 2011 1:10 pm
Since the procedure described "file away the natural tooth crown" does not fit with coronectomy D7251 you must use an unlisted oral surgery procedure code D7999. The "root cap" does not have a specified code either, therefore your choices are D2940 if the restorative material is temporary, D2999 unspecified restorative procedure, by report if the (more)
Admin
asked 14 years ago by
ADCA Admin
1
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51
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My patient wants a full denture. The patient wants to keep just one tooth root and remove the tooth crown. Should I code the denture as an overdenture? The dr. needs to file down the crown so only the root is left. He then plans to place a layer of composite over the top of the tooth. How should I code these procedures?
Admin September 21, 2011 12:49 pm
If the dentist plans on attaching the denture to the roots or implants then the answer is YES! You would code this as an overdenture. D5860-D5861
Admin
asked 14 years ago by
ADCA Admin
1
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56
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We refer patient to a Oral Surgeon, they pulled tooth out and put sutures. Patient came to our office to remove sutures. What code should we use? Since we did not pull his tooth but remove his sutures. Thank you
Admin September 21, 2011 9:17 am
Since there is no specific code for suture removal you would use D7999 (unspecified oral surgery procedure, by report). You will need to send a short narrative along with the claim explaining what was preformed.
Admin
asked 14 years ago by
ADCA Admin
1
answer
183
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We are having trouble getting our pano D0330 and bite wing D0272 and D0274 paid when they are performed on the same day of service. Is there any other way of coding these services in order to receive payment? Thanks
Admin August 24, 2011 11:00 am
Unfortunately you are not able to code this as a full mouth series because there are no PA films included. If you are taking a pano and six bitewing films, you are limited as to coding. The way you have coded this is appropriate and correct. If the carrier is not paying on this claim (more)
Admin
asked 15 years ago by
ADCA Admin
1
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689
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We use code D9230 for Nitrous Inhalation, can we also use D9248 for Halcion administration or would it be better to use D9920 Behavior modification w/ a narrative for a patient that has high anxiety before and during a dental procedure?
Admin August 17, 2011 8:26 pm
D9230 is an appropriate code for Nitrous Oxide Inhalation, and D9248 would be the most appropriate for Halcion.
Admin
asked 15 years ago by
ADCA Admin
1
answer
561
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When filing dental insurance for a crown, D2751, and we are not providers with the insruance nor do we have any agreements whether to file on prep or seat date, doesn't the ADA recommend we file our claim on the prep date?
Admin August 5, 2011 7:54 am
According to the ADA it is acceptable to submit a claim for services on the prep date, however, most carrier guidelines require the claim to be submitted on the seat date. Whether you are contracted or not has no bearing on how a carrier pays a claim, they will follow their particular guidelines on reimbursement. (more)
Admin
asked 15 years ago by
ADCA Admin
1
answer
1941
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I found the code for smoothing a tooth (odontoplasty D9971), can I use that code in conjunction with palliative treatment D9110?
Admin August 5, 2011 5:39 am
As long as it is not in connection with the same tooth, most carriers will not allow any other codes in connection with D9110 other than radiographs (x-rays).
Admin
asked 15 years ago by
ADCA Admin
1
answer
688
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Good Morning. I need a code for smoothing a tooth. I know that there is one, but I can't remember where it is.
Admin August 5, 2011 5:35 am
D9971 Odontoplasty 1-2 teeth; includes removal of enamel projections.
Admin
asked 15 years ago by
ADCA Admin
1
answer
104
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0
When the doctor notes two separate areas of decay on a single tooths O surface, for example spotting decay on a molar tooth and the doctor calls out "O, and OL", how should we file this?Similar situation when there is decay on the O, and the doctor wants to seal up the groove and completes a connected OL & OB composite. Should it be filed this way, as two - two surface fillings or is it a 4-surface filling? Or should it just be considered an O filling, even if the doctor fills any remaining L or B grooves? We had a lot of confusion on this!
Admin July 29, 2011 9:04 am
If the filling is solely on the Occusal surface it is considered a 1-surface filling regardless of the location of the decay. Example: If the doctor drills into the occlusal surface and the lingual surface of the tooth then it would be considered a 2-surface filling, if he drills into the occusal, lingual and buccal (more)
Admin
asked 15 years ago by
ADCA Admin
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