Ask the Coder (541)

You're stating that the insurance downcoded the procedure based upon the evidence of the perio chart? It would depend on if you are in network or out of network with the insurance company as to how they process the difference when they downcode the procedure. If you are in network, it's likely that they process (more)

Well truly, medical should be billed first. Also, the answer is going to depend on if the service is covered under the patient's medical plan. Since it's a pano or bitewing... it's likely that it will not be covered medically. If it is... be sure that you have a good medical diagnosis to support the (more)

CEU's are not required

D1206 Fluoride Varnish can be appropriate for any person no matter their age. That being said, most insurances will not pay for adults to have D1206. It is best to communicate to the patient they will likely be responsible for the cost of the D1206. There would be two reasons to apply D1206 to a (more)

No, the dentist must be present and review the patients chart for D0120 to be billed.

CDT code D0363 that was used for cone beam three dimensional image reconstruction has been deleted.

Hi, Which are you submitting? The missing tooth or the crowns?

Yes, the extraction should be billed out by the facility/provider who performed the service.

Did you submit the medical records for the necessity of the procedure? Be honest and open in your documentation - send medical records indicating the necessity of the procedure and a diagnosis to support what was done. You may want to also include a detailed letter that is descriptive of the necessity along with the (more)

D9310 should only be used on the initial examination where a referral was requested. If continued examinations are performed the appropriate code selection would be D0140.