Ask the Coder (539)

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.

The standard is 13 years and older

D9630: drugs or medicaments dispensed in the office for home use; Includes, but is not limited to oral antibiotics, oral analgesics, and topical fluoride; does not include writing prescriptions.

According to most carriers it should be billed out on the delivery date.

You can also add the quadrant which will be LL quadrant 3.

Except that D7550 is removal of sloughed off bone due to infection and blood supply. The RVUs assigned to this for payment do not constitute removal of a simple bone spur.

No, you would use an unlisted code and give a brief explanation...you should note most carriers will consider adjusting a high spot on a filling inclusive of the original procedure.

This code is to be used on a per visit basis, some carriers will allow for it to be billed per quadrant while others consider it to be a one time billable charge. You need to review your carrier contracts for exact usage.

9310 is the correct code. Consultations (D9310) and exams often share the same frequency, by any chance was the D9310 denied due to frequency for exams had been met? Also, many dental plans will consider the exam inclusive of any other treatment performed that day and it might have been denied due to payment processing (more)

If the provider is not part of your practice/facility this is a billable charge, and would be done so using CDT code D9999. This code would also be appropriate as a non-billable code for a provider in the same practice/facility.