Ask the Coder (539)

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.

Some carriers may consider this inclusive as the doctor removing the bone spicule was the one who removed the tooth initally. However, if the carrier allows the charge you would code it as D7530 (removal of foreign body) due to the fact that a bone spicule by defination is a small sliver of bone that (more)

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.

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.

No, you may charge one or the other but not both.

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.

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.

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.

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.