Ask the Coder (537)

No, you must adhere to the contractual obligation set forth by the insurance carrier.

You need to find out a few details first. If the patient is the subscriber of both plans; the plan that has been effective the longest is primary. You will need to send eligiblity reports showing the carrier who has been effective longer both eligiblity reports. If the patient is the subscriber on one and (more)

It is not a good idea to take x-rays after a cleaning (D1110) for the fact you just stated above. If a patient has moderate to severe plaque/claculus you want it visible on the x-ray. In order to bill root planning/scaling D4341/D4342 you need to the following; 1. Indications of moderate to severe calculus 2. (more)

The first question you need to ask would be "Why is an Endodontist performing a 6 month check-up?" If it is to check the status of a RCT performed on a patient, this is typically considered inclusive. None-the-less, since there is no specific examination code for a 6 month check-up from an Endodontist and no (more)

NO, a biller can not make a correction in the doctor's note. Any and all corrections must be made by the rendering provider.

The general dentist should be using CDT codes D0150 for the exam provided he is documenting and completing a through exam; otherwise D0140 is the most appropriate code and D0330 for the panoramic film. The specialist should bill D0160 provided an exam is "medically necessary" from the specialist and documentation is supported.

You would charge this code one time as the code description clearly states (odontoplasty 1-2 teeth), since you have two teeth involved and they are side by side you would get this code one time only.

What if after crown removal the tooth is deemed unrestorable and ext and implant are reccommeded?

Without knowing the specifics of what he plans to do (i.e. clean out infection, remove non-vital bone, ect.) the most appropriate code is D4999. This code must be accompanied by a narrative describing the procedure.

It depends on what treatment you will be performing after you remove the old crown, will you be extracting the tooth, replacing the crown, putting in an implant...your question requires more information.