Ask the Coder (537)

Usually this means exams,x-rays and cleanings only. However you should contact the carrier for specifics on what they consider to be included in "preventative & diagnostic " services.

You are only allowed to give a contracutal adjustment on insurance patients; if you are not charging the patient their co-pay or co-insurance amounts this is considered fraud. It is considered highly inappropriate!

You will need to submit the claim to medical on a CMS-1500 form and attach a copy of the dental EOB to the claim. You will use CPT code 41899 in place of the D7111. For the D9248 you will need to list the drugs used and their appropriate HCPCS code.

2016 books are required for all 2016 exams.

The place of service code would depend on whether the patient was an inpatient or outpatient of the hospital Inpatient - 21 Outpatient - 22 Ambulatory Surgical Center - 24

Each carrier has there own set criteria, however, in general the following must be present. 1. pocket depths must be 4mm-5mm or higher 2. Bleeding must be present 3. Gross plaque and/or calculus present 4. Either periodontal surgery was performed or full mouth debridement prior to RPS

The association requires 12 CE's per year...these CEU's must be uploaded to your members dashboard under the submit CEU's tab before December 31st of each year.

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The limited exam would be billed out at D0140.

76376 3D rendering with interpertation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality; not requiring image postprocessing on an independent workstation.