Ask the Coder (539)

I would contact the insurance carrier and ask for an explanation as to why they are requesting you to change your CDT code when it does not match the description of the procedure performed.It could be that the carrier only covers full cast nobel metal crowns. Unfortunately, this is a carrier issue not a coding (more)

D0180 cannot be billed by the hygienist as their range of practice does not include exams...this may only be billed by the DDS

D9951 would be considered inclusive in the primary procedure of D3330. It is expected that once a root canal is performed on a tooth the dentist would adjust the occlusal surface.

As long as the patient is condisdered by the dentist as a periodontal patient and the patient has enlarged pocket depths of 5mm or more you may bill the D4910.

decidious teeth usually do not have what we recognize as root tips, you would still use D7111 for decidious teeth.

Each carrier has there own set criteria, however, in general the following must be present. 1. pocket depths must be 4mm-5mm or higher 2. Bleeding must be present 3. Gross plaque and/or calculus present 4. Either periodontal surgery was performed or full mouth debridement prior to RPS

Generally speaking they must bill under the supervision of a dentist. There are some procedures they may perform without the presence of a dentist such as routine cleanings, and x-rays. However the x-rays MUST be read by a dentist.

Medicare has a handbook on correct billing guidelines for dental procedures: http://cms.hhs.gov/site-search/search-results.html?q=billing%20for%20manual%20for%20dental Article 140

The most appropriate code would be D7970

The code D2751 includes the crown prep, anesthetic, temporary crown and permanent crown. It does not include a crown build up, crown lenthening, or pins...these are billable seperately.