American Dental Coders Association | Dental Billing & Coding Certification Online

Certifying Dental Billing and Coding Professionals Nationwide

  • Accreditation
  • Login
  • My Cart

Ask the Coder (541)

Ask a Question
« Back to Full Questions List
    Answers
    Question
    1
    answer
    0
    I need to know the correct way of handling failed and/or ongoing procedures and how to bill for them. This has been a debate in our office. If a patient's restoration has failed, whatever the reason, and they have insurance, do you report that to the insurance company? For example, a patient gets an amalgam filling and six months later it needs to be redone. What is the most appropriate course of action, doing an adjustment in house, or filing it to the insurance company and adjusting it off afterwards? Some do not want to file and some do. If it was a self pay patient we would adjust it off and not make them responsible. Our insurance patient's are not responsible either, but is it necessary to report it to the insurance company? Please let us know the most appropriate course of action. Thank you.
    Admin December 2, 2016 9:47 am
    You always bill any treatment performed to the carrier. If you utilize ICD-10-CM codes on your dental form the amalgam re-do should be covered please look at diagnosis codes K08.5 unsatisfactory restoration of tooth
    Staylor2964
    asked 9 years ago by
    Shannon Taylor
    1
    answer
    0
    Hi, I just recently got my log in information and so I'm a bit behind. Can you help me get started… I tried to navigate through the site and I'm not sure what tabs to click for the training modules to access the course work?
    Admin July 21, 2016 2:15 pm
    Hi Raymond, You are never behind on our on-demand classes. I noticed you are using an aol email this is a Microsoft email and you may not receive login information. Please contact our Director of Education Mindi Rothans 800.300.0239 x105 to update your email and receive login instructions.
    Admin
    asked 9 years ago by
    ADCA Admin
    1
    answer
    0
    How would you code the following? Patient presents to smooth off #9-ILF, chipped recently and originally placed 2 days earlier. Removed No decay, VOCO (prime/bond), Flowable Composite Shade: A2 finish, polish, checked occlusion.
    Admin June 17, 2016 7:46 am
    Since this was a restorative material failure and it was composite and codes only exist for crown, inlay, onlay, and veneer the most appropriate code would be D2999 with a brief narrative to accompany the claim.
    Admin
    asked 9 years ago by
    ADCA Admin
    1
    answer
    0
    For example the office billed a Pano and bitewings. Insurance plan paid at an alternate benefit of FMX can we bill the patient the difference? I was not sure if alternate benefit was the key word.
    Admin September 22, 2016 9:59 am
    If the explanation of benefits states there is a patient portion you may bill the patient their cost, however if the benefit is paid at 100% you may not bill the patient. The best option is to appeal the claim stating 14-22 films were not taken at this visit is was a pano and bitewings (more)
    Admin
    asked 9 years ago by
    ADCA Admin
    1
    answer
    0
    What is the appropriate code for Space Maintainer repair.
    Admin July 8, 2016 5:55 pm
    If you had to re-cement or re-bond the space maintainer the code would be D1550. If you had to place a new space maintainer the code would be D1999 accompanied by a brief narrative as to why the space maintainer had to be replaced.
    Admin
    asked 9 years ago by
    ADCA Admin
    1
    answer
    0
    how do I sign up for the CDC exam
    Admin December 3, 2016 4:11 pm
    Go to the website and click Certification - CDC
    Admin
    asked 9 years ago by
    ADCA Admin
    1
    answer
    0
    Good morning,i want to know if i am appearing for CDC exam in October 2016, i should purchase 2016 coding books or 2017? Which month the books are effective.
    Admin July 23, 2016 11:12 pm
    2016 books are required for all 2016 exams.
    Admin
    asked 9 years ago by
    ADCA Admin
    1
    answer
    0
    If a patient is scheduled for an extraction but cant be done due to their blood pressure being to high and we refer them to the clinic, what code can we bill?
    Admin October 5, 2016 7:48 am
    D0140
    Admin
    asked 9 years ago by
    ADCA Admin
    1
    answer
    0
    Is there a code for a implant crown or can you use D2740.
    Admin July 9, 2016 9:45 am
    The code for single crown implant supported would depend on the type of crown being placed code range D6065-D6067 Porcelain/ceramic D6065 PFM D6066 Metal Crown D6067
    Admin
    asked 9 years ago by
    ADCA Admin
    1
    answer
    0
    can insurance companies create their own billing for FMX? the CDT books says usually consist of 14-22 PA's and BW's but I'm being told by the dental biller that some insurances want the FMX code when less than 14 x rays are done. I would like clarification if this is ever appropriate to do. thanks.
    Admin January 1, 1970 12:00 am
    Coding guidelines state 14-22 periapical films including bitewings must be present however, some insurance companies are paying out an FMX when a pano and bitewings are taken. The best course of action is to appeal the claim stating 14-22 films were not present at this visit.
    ryazzie
    asked 9 years ago by
    Rena Yazzie
    « Previous 1 … 43 44 45 46 47 … 55 Next »

    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
    • Facebook
    • Instagram
    • Pinterest
    • Twitter
    • YouTube

    Quick Links

    • ADCA Certification Verification
    • Information For the Dentist
    • Dental Billing & Coding 101 for 2025
    • Contact Us

    ADCA Legal

    • National Member Advisory Board
    • Privacy Policy
    • Terms and Conditions
    • Cookie Policy
    • Disability Discrimination Policy
    • Data Protection Policy
    • Health and Safety Policy
    • Equal Treatment Policy
    • Code of Conduct

    American Dental Coders Association