Ask the Coder (539)

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.

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.