Ask the Coder (544)

It is inappropriate and fraudulent to code two separate fillings on the same tooth when a more appropriate code exists. This kind of billing is called unbundling and is considered fraudulent and abusive. Rule of thumb: always code to the highest level of specificity, meaning if a more appropriate code exists use the more appropriate (more)

what arch should i use

76376 3D rendering with interpertation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image postprocessing on an independent workstation.

D3332 (incomplete endodontic therapy; inoperable, unrestorable or fractured tooth.

If a full mouth debridement was performed you should use CDT D4355.

According to ADA 2011-2012 code sets this is a valid code and may be used.

Most likely Medicare will not cover this procedure, you may contact Medicare and see if they will pre-authorize the procedure based on the systemic disease (cancer) and the need for a prosthesis to return normal functionality of chewing.

No, in order to bill for a D1120 removal of plaque, calculus and stains from the tooth structure must be performed with a prophy angle not a toothbrush.

According to NY State Medicaid Dental Procedures and Code Guidelines, it does not state that an exam and cleaning must be preformed on the same visit. However, in most instances it is preferable to have the cleaning, exam and x-ray performed at the same time. There is no right or wrong on this particular issue.

This would not be appropriate as a D0180 covers similiar aspects as a D0150. Having both of these exams performed within a couple of weeks may raise a concern with the insurance carrier. Having said that as long as the documentation is clear, present and the exams are necessary there is no rule stating you (more)