Ask the Coder (539)

In order to bill medical insurance, you would need to contract/use an online company to bill medically or purchase a stack of CMS-1500 forms and complete the forms in your office to send to the insurance company. You would also need to be sure that you have a CPT code book and ICD-10-CM code book (more)

Unfortunately, I can't exactly explain why a payor would request a tooth surface, but it may be a requirement of the plan for the code. This is probably given to be sure that duplicates are not billed. Also, they are typically subject to a 5–10-year limitation. There can be quite a few limitations to these (more)

The following article will aide you in determining how to assign medical necessity for patients you believe to be high risk. Please click on the link or copy and paste into your browser: https://www.aapd.org/globalassets/media/policies_guidelines/bp_cariesriskassessment.pdf

It is very likely that the insurance is going to deny the second D9222 and D9223. I would submit medical records indicating the need for general anesthesia the second time (twice in a day). This is a rare occurrence, and it's likely that it will be denied as you already had the patient sedated once (more)

This question is to vague please give more detail...

I found this on the webpage: https://www.dentalclaimsupport.com/blog/examining-cdt-code-d2940-do-you-place-protective-restorations-at-the-emergency-appointment#:~:text=The%20nomenclature%20defines%20D2940%20as%20a%20protective%20restoration.,outside%20the%20mouth%20then%20placed%20on%20the%20tooth This type of restoration is accurately documented and reported to the payer using code D2940 which was revised a few years ago. The previous code nomenclature defined this code as a sedative filling. The current code language includes a revised nomenclature and a descriptor. D2940 protective restoration Direct (more)

When you say "drugs" be more specific. Are you referring to other sedative medications? I cannot see why other medications would not be covered because moderation sedation was used. This may also be payer specific and/or plan specific. You might also want to document the reason for needing any additional medications (ie: patient was autistic (more)

What I believe you are asking is can a dentist document in the patients chart for another dentist? The answer is simply NO the dentist who provided the service must document . The only time another dentist may provide the documentation is if he/she was present at the time of procedure or examination and aided (more)

Since the patient had 4 quads of SRP, the patient is a PM at that point. Just as an FYI, the first PM appointment is usually 90 days post SRP. So, for example, Delta is denying our D4910's within 90 days of SRP. This is a WRITE OFF. Not billable. Since it was NOT past (more)

D5282 removable unilateral partial denture one piece cast metal (including clasps and teeth), maxillary Yes, this code requires either a tooth number or quadrant to accompany it on the claim form.