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    When the doctor completes a posterior resin filling D2391, but wants to seal any additional grooves connected to the cavity surface, can we also use code D1352?Or, can we use code D1352 if the doctor fills a groove not in connection with the cavity getting filled with the D2391?
    November 15, 2011 2:31 pm
    Yes, you may use D1352. However, you must meet coding guidelines on this code. Meaning you must be able to prove the patient is moderated to high risk caries patient and needs the sealant placed to reduce the risk of further caries.
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    We could not apply varnish fluoride in the office on little kids due to cooperation. We send varnish fluoride home so parents could apply. Can we charge for varnish fluoride to insurance?
    November 4, 2011 6:13 am
    No, you may not bill this to the insurance. Coding guidelines clearly state topical flouride varnish must be delivered under the direct supervision of a dental professional and delivered in the dental office.
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    You have a patient that is scheduled with your hygieneist and your dentist in the same day.Your hygieneist does perio charting and discusses perio disease in depth with the patient. The patient then sees the dentist for there appointment and he does panoramic film and a complete comprehensive dental exam.Can you charge D0180 and D0150 at the same visit<
    October 28, 2011 11:19 am
    No, you may charge one or the other but not both.
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    Are there any dental insurance companies that cover the D1330 Oral Hygiene Instructions? Am I obligated to submit this charge to the patient's insurance when they are not paying for this service?
    October 26, 2011 1:04 pm
    Some carriers cover this charge for patients with gross periodontal disease, you must have a "medical necessity" to charge for the OHI in order for it to be paid. Some examples would be gross periodontal disease, moderate to severe gingivitis, and gross dental caries.
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    If a Dentist has an anesthesiologist come to his/her office to administer and monitor an IV sedation procedure, can the dentist submit an iV sedation claim using the deep sedation code even if the anesthesiologist was the one to perform the action while the Dentist did all of the dental work? And if not, is there a different code I could use?
    October 8, 2011 7:48 pm
    No, only the treating doctor may bill for his or her services. There is no special code for the dentist, he/she may only collect on the work performed and the anesthesiologist may collect on the work he/she performed.
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    If x-ray were not diagnostic, do we still charge for them?
    October 8, 2011 6:36 am
    Yes, anytime x-rays are taken they should be charged out so the insurance company is able to keep track of procedures performed on the patient.
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    My PT wants a set of upper and lower partial dentures. I'm using codes D5213 and D5214. The CDT book says these codes should include "any CONVENTIONAL clasps." My PT needs a special type of clasp, in addition to the standard clasps, called a flexi clasp which will incur higher lab fees for our office. Is there a code for additional, non-conventional, clasps?
    October 6, 2011 6:24 am
    You may use D5862 (precision attachment, by report) You must explain in the "Remarks" area of the claim form what type of attachment you are using (i.e. flexi clasp) and why this type of clasp is necessary.
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    Do you have a sample of an appeal letter for a denial for treatment that had been given prior-authorization?
    October 6, 2011 5:15 am
    At this time we do not have the letter you are requesting, I will forward this request to the Director of Education for a sample letter to be created. Please check your members area within the next 3 weeks for your letter.
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    If single bitewing was taking, can it be charge out as a PA?
    September 28, 2011 6:53 am
    No, it should be billed as a single bitewing CDT code D0270
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    Oral Surgeon pulled wisdom teeth. Patient came back to our office for follow up and make sure TE sites ok. What code should i use for visit?
    September 22, 2011 10:05 am
    A follow-up visit after extractions is not billable, it is considered inclusive of the primary procedure.
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