Ask the Coder (415)

Shoeing the cusp is merely shaving a projection of the masticating surface and would not be considered a fourth surface. Therefore billing for a 4 surface restoration would be incorrect. A more appropriate way of coding would be to code the three surface restoration along with D9551 occlusal adjustment for the shoeing, as long as (more)

Please visit our forms section in your members dashboard for a generic template on medical necessity. Simply fill in the blank areas to support your reasoning for "medical necessity." As each patient's needs for treatment are different I cannot give you the reason for medical necessity, there must actually be medical necessity for the treatment.

Therapeutic drug injections are coded to medical carriers by the actual drug being used. If the drug you are using is Decadron you have the correct code of J1100. This code is placed in the procedure code of the CMS-1500 form just as your other CPT codes are, it is box 24D. You do not (more)

Depending on the device, if you are using TAP appliance you would use 21089 for the appliance and 99002 for the handeling of the appliance. You need to be more specific as to the type of sleep apenea device your are utilizing. Medicare will only pay for an appliance if a sleep study has been (more)

1) Tapp appliance 21089 for appliance and 99002 for handeling must have a narrative accompany claim. 2) New patient code range 99201-99204 Established patient code range 99212-99214 3) Panorex 70355 Full mouth 70320 4) TMJ what procedure? 5) No cross code available use exam code New 99201 established 99212 6) New patient code range 99201-99204 (more)

Typically they are answered within 72 hours depending on the level of difficulty of the question being asked.

There are over 50,000 diagnosis codes in the ICD-9-CM book, you must utilize the code that best describes your patient's condition.

The most appropriate CPT code is the unlisted code 21089, this code requires a narriative to accompany the claim.

The appropriate code to utilize with a patient that has a diagnosis of periocoronitis and has the pericornal gingiva excised or removed is D7971. Using an inappropriate code just because it pays is considered abusive and you may be audited and fined. You may try billing the claim to the Medical carrier using 41821 and (more)