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    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.
    January 26, 2013 1:52 pm
    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.
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    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 :)
    January 25, 2013 10:20 am
    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.
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    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?
    January 23, 2013 12:38 pm
    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)
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    Should incipeint area on occlusal,be billed as D2391 or D1352?
    January 22, 2013 3:20 pm
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    Can an ultasonic cleaning be billed using a D1110?
    January 17, 2013 11:14 am
    This is really at the carriers discretion, the way the code reads D1110 is for removal of plaque, calculus and stains from the tooth structures in the permanent and transitional dentition. It is intended to control local irritational factors. An ultrasonic cleaning will by defination do the same as a prophylaxis, however, it is not (more)
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    We are a pediatric dental office and at times doctor treats patients in an OR hospital setting (out-pt) when necessary. He performed multiple extractions under code D7140 (Extraction Erupted Tooth EXR). Is there an equivalent CPT code that can be billed to the pt's medical insurance first or should I simply bill dental? Thank you, -Shellea
    January 15, 2013 1:50 pm
    Simple extractions D7140 are usually not covered by the medical carrier uless it is due to trauma, injury, or there are more than 7 consecutive teeth in a row. If this is the case you would use CPT code 41899 and send a short narrative along with the claim explaining the circumstances.
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    I work in a pediatric dental office, and my doctor also treats some of our pt's in an OR setting at the hospital when they require multiple fillings coupled with dental anxiety etc. I understand that doctor has to provide the hospital with an ICD-9 diagnosis code so they can properly bill medical insurance and I bill dental (using the D-codes unless able to bill medical first). My question concerns the CPT book. Am I correct in understanding that this book will come into play if I bill medical insurance only NOT dental using the 1500 form? How does this work in office as oppose to in treatment being done in the hospital? Thank you, -Shellea
    January 14, 2013 8:47 pm
    CPT codes are only used when submitting claims to medical carriers on CMS 1500 forms, you do not use CPT codes for dental claims submitted to dental carriers on ADA2006 forms.
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    I would like to know the most specific code for generalized, gross dental decay using the ICD-9. Would it be code 521.03 Dental caries extending into the pulp? Or is there a better code that uses the terms "gross decay?" Thank you for your help. -Shellea
    January 14, 2013 7:45 pm
    The best ICD-9-CM code for generalized, gross decay is either 521.03 dental caries extending into pulp as gross caries are usually classified as extending into pulp. However, if the dentist does not make mention of the carries extending into the pulp a better code is 521.09 other dental caries or 521.00 dental caries, unspecified as (more)
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    Can you please explain D1208 vs D1206 since the new CDT 2013 Dental Revisions have been done? We see predominately Medicaid patients and Medicaid only covers D1208 but some of our providers want to bill D1206 for all visits. I need a better understanding of when it is appropriate to bill D1206 and when to bill D1208.
    January 10, 2013 5:05 pm
    In the Preventive section of the CDT manual, a new procedure code was added for topical application of fluoride D1208. The nomenclature was revised for D1206 to indicate topical application of fluoride varnish. Two codes, D1203 and D1204 were deleted. Simply put D1206 is for a varnish while D1208 is for fluoride. The appropriate code (more)
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    Are there any resources available for orthodontic billing and coding specifically? I work for Kool Smiles Corporate and I'm trying to find a course that will allow me to become certified as an ortho billing specialist.
    January 6, 2013 1:05 pm
    The ADCA will be coming out with an orthodontic specific course and credentials late 2013.
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