American Dental Coders Association | Dental Billing & Coding Certification Online

Certifying Dental Billing and Coding Professionals Nationwide

Ask the Coder (532)

Ask a Question
    Answers
    Question
    1
    answer
    0
    Is there a D-code that fits the following scenario: Pediatric dental office, pt (6 years old) presents with dental anxiety/hesitation; Dr would like to see him every 4 months for what he calls a "desensitizing appointment" which aims to make the pt feel more at ease in the dental office. Thank You
    Anonymous January 1, 1970
    While "desensitizing appointments" are a common occurance in Pediartic offices this is usually done at the doctors expense. There is no specific dental code for this type of appointment and most carriers will not pay for this type of visit. You may try to bill with CDT code D9999 and send a supportive narrative giving (more)
    1
    answer
    0
    What is the best ICD-9 diagnosis code to use for a pt with Cerebral Palsy who must be treated in the OR under general anesthesia? Thank you
    Anonymous February 12, 2013
    The correct ICD-9-CM code for Cerebral Palsy is 343.9
    1
    answer
    0
    Do EOB's get scanned into a pt's chart? If so, what is protocol for insurance EOB's that are returned concerning multiple pt's?
    Anonymous February 6, 2013
    According to HIPAA Explanation of Benefits should not be part of the patients chart, any financial information on the patient should be stored in a seperate area. If your particular software system has a seperate financial area from the chart documentation area then yes, it should be scanned and stored in the patient financial area (more)
    1
    answer
    0
    When it comes to double coverage, and we submit a claim to the primary insurance first, does this always mean medical coverage? I remember hearing that Primary means medical? How does this come into play in the dental field? We see pt's in our private practice as well as in hospital out-pt OR setting when necessary.Thank you for any clarification.
    Anonymous February 5, 2013
    If a patient (child) has dual insurace meaning they have two dental plans the primary insurance will depend on several factors. 1. Who's birthday falls first mother or father 2. Who's plan has been in effect the longest 3. Is there a court order determining custody and insurance In order to find the answer you (more)
    1
    answer
    0
    > If a young child had extensive restorative dental work completed in > an out-pt OR hospital setting, as well as 8 extractions (D7140), how > do I go about billing medical for the extractions. I was told in a > previously submitted question that CPT code 41899 can be used to bill > medical using the CMS-1500 form if more than 7 extractions were > performed. > > I am a little confused on how to approach the 1500 form. Do I need to > include all of the D-codes charged out for the apt as well? The > extractions are the only ones I can submit to medical insurance under > code 41899 to my understanding. > > Or do I only bill code 41899 eight different times on the CMS-1500 > form and not include the other D-codes? > > Would this process change if the insurance provider is the same for both the medical > and dental benefits? > > Thank you for you time. I really appreciate any clarification I can > get.
    Anonymous February 5, 2013
    If billing medical for the extractions you will use 41899 and list it however many extractions were performed. In box 19 of the CMS-1500 form you will put D7140 teeth involved and list the teeth numbers. You will need to check with your carrier for specific guidelines on extractions and what is and is not (more)
    1
    answer
    0
    If a pt. presents with cerebral palsy and mental/developmental issues- what is the best ICD-9 Diagnosis code? Thank you
    Anonymous January 31, 2013
    The ICD-9-CM code for cerebral palsy is 343.9 You must be more specific on the type of mental/developmental issues in order for a code to be given.
    1
    answer
    0
    After a pt has been seen in an OR out-pt setting under general anesthesia for dental treatment, and is then seen back in the private practice two weeks later for a post-operative exam; What is the best CDT code to use? Thank you.
    Anonymous January 26, 2013
    Usually the post operative treatment will be considered inclusive in the primary procedure and therefore not billable. However, if the carrier allows a fee for the post-operative visit you may use D0140 limited oral evaluation.
    1
    answer
    0
    What is the best way to describe the importance of ICD-9 diagnosis codes in the following situation: A pediatric dentist has his own practice, but also treats pt's in a hospital OR setting at times. Where do the ICD-9 codes come into play as far as treatment notes are concerned. The hospital will bill for the facility and anesthesia (the dental office will submit the D-codes). Is there protocol? I understand that the ICD-9's are diagnosis codes that help explain the "situation" per say. In a dental setting-where do these codes get noted? Thank you for your time :)
    Anonymous January 25, 2013
    All diagnosis made for the patient should be noted in the chart, the ICD-9-CM codes do not need to be billed on the ADA2006 claim form.
    1
    answer
    0
    I need to code- get ICD-9 codes for a pharmacy for arestin- the conditions would be: Chronic Advanced periodontitis, and generalized marginal pappillary severe gingivitus.I am also trying to figure out what the correct bonegrafting codes we should be using. WE do them often, sometimes prior to implant, and soemtimes just for obtaining a level of bone for a prosthetic placment at some point. WE always do them with extractions and most of the time we also place the tissue- Mucograft.Is there a code for placing arestin when the patient gets it through a pharmacy? Either medical or dental?
    Anonymous January 23, 2013
    ICD-9-CM: 523.40 Chronic periodontitis, unspecified The code for generalized marginal pappillary severe gingivitis would depend on if the gingivitis was Acute or Chronic and if it was plaque induced or non-plaque induced your options would range from 523.00 to 523.11/ in order to give the correct code this needs to be more specific. Bone grafts (more)
    1
    answer
    0
    Should incipeint area on occlusal,be billed as D2391 or D1352?
    Anonymous January 22, 2013
    1 … 38 39 40 41 42 … 44

    Corporate Profile

    American Dental Coders Association
    9015 W Union Hills Dr Ste 107 #314
    Peoria, AZ 85382
    1-833-469-2322

    American Dental Coders Association BBB Business Review

    American Dental Coders Association