Ask the Coder (532)

You are only allowed to give a contracutal adjustment on insurance patients; if you are not charging the patient their co-pay or co-insurance amounts this is considered fraud. It is considered highly inappropriate!

Yes, you may bill D9220 general anesthesia in conjunction with D9610 (injection of antibiotics, steroids, or anti-inflammatory drugs) for simple extractions.

Most carriers consider major surgery to consist of 7 or more contiguous teeth. Each carriers idea of major surgery is different, to get this in writing you will need to look up your carriers utilization review guidelines.

Yes, you are required to maintain 12 CE's per year. You are also required to be a member in good standing to keep and maintain your CDC credential. You may find more information on our website under the CEU Center tab.

This would depend on why a physician is administering the fluoride and not the Dentist. The ICD-9-CM code explains why a procedure is being performed. If you are administering fluoride treatment due to gross carries or heavy plaque you would use the appropriate ICD-9-CM code to support your billed charge.

If a patient has been seen in the office in the past 3 years by any provider in the practice they are considered an established patient. It does not matter if you are billing medical or dental. To answer your question specifically you would use and established patient E/M code,

Fluoride codes have changed for 2013, the following are the only fluoride codes to be used. All other fluoride codes have been deleted. 1. D1206 - to be used on both child/adult when a fluoride varnish has been applied 2. D1208 - to be used on both child/adult when topical fluoride has been used (i.e. (more)

Since consult codes are no longer recognized or paid by insurance carriers, depending what the DDS saw the patient for and what part of the hospital the patient was seen you would use the following code set series. ER 99281-99285 In-Patient Hospital 99221-99223

It would depend on what other service you are billing D4211 with and what the carriers Utilization Review for the code states. You would need to be more specific on what you are billing D4211 with in order to receive an appropriate answer.

Most carriers would consider 7 or more contiguous teeth to be considered major surgery...yes you would use 41899 as the correct CPT code. This procedure usually has a global period of 30 days however, some carriers state the global period is 14 days. You will need to check your carriers utilization review to find out (more)