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Pt seen to stablish care. Procedure code used D0150 the next day patient seen for a limited examination D0140 and extracted a tooth. I am curious if this will be considered over charging on exams, as pt just had a comprehensive exam the day before.
Angela Miller October 25, 2023 6:49 am
If these two had taken place weeks apart, I think it would be fine. Doing a comprehensive one day and a limited the next day, my question as an auditor was the extraction planned on the D0150 exam and scheduled for the next day? If so, the D0140 I would say is overcharging unless you (more)
asked 1 year ago by
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What codes can we use if exams and cleanings were done at separate appointment? Can we use z13.84 if exam was done only?
asked 1 year ago by
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KK March 26, 2024 9:16 am
I went to Aspen Dental to have a wisdom tooth removed. They made an appointment for the oral surgeon the following month at same office. The oral surgeon pulled the tooth. I was billed for a D9310 code. Which I believe is inaccurate.
asked 12 years ago by
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My dentist referred me to another dentist at another company for procedure D3348. After the procedure, I was billed D9310 in addition to D3348. I personally did not need a consultation and only required D3348. Do I have to pay this invoice and if not...
Anonymous June 29, 2024 5:11 pm
I think yes he can charge you. D9310 is consultaion- diagnostic service provided by dentist or physician other than requesting dentist or physician. It means a patient encounter with a practitioner whose option or advice regarding evaluation and or management of a specific problem may be requested by another practitioner. The consultation includes an oral (more)
asked 1 year ago by
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If I send a claim to a primary insurance and they pay a portion and have a contractual adjustment that covers the remaining portion of the balance leaving no patient balance, is it appropriate to send the claim to the patients secondary insurance hop...
Austinida April 8, 2025 1:29 pm
The claim should be submitted to secondary insurance even if there is a remaining balance. It's crucial to ensure that the patient's primary and secondary insurance records accurately reflect their procedure history.
asked 10 months ago by
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Admin May 17, 2013 5:31 am
Since there is no current code listed for zirconia crowns depending on the carrier they will request CDT code D2999 and a narrative as to the "medical necessity" of this material rather than a standard crown. Some carriers will allow CDT code D2783, however, you will need to check with your carriers utilization review guidelines (more)
asked 13 years ago by
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Dentist referred me to an oral surgeon who was out of network so I choose a different surgeon. I had a referral to the first oral surgeon but not for the actual provider seen. My initial visit was coded as D9310 which is not covered by my insurance, ...
Austinida June 17, 2025 8:02 am
Hello! Since you were referred to the specialist by another provider, and not seen by the original referring dentist, the code D9310 (Consultation- Diagnostic service provided by dentist or physician other than requesting dentist or physician) was appropriately applied. Alternatively, D0160 ( Detailed and extensive oral evaluation, problem-focused, by report) could also be used, as (more)
asked 1 month ago by
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We have patients that come into the hospital due to issue where they can’t have the restorative procedures done without anesthesia. My question is, under anesthesia, if provider performs radiographic images and bitewings, can it be coded with a resto...
kmoney October 25, 2021 1:57 pm
You can certainly charge out radiographs with restorations. You have to be mindful of the plan limitations set in place by the carrier. If a patient has had a full mouth series done within a specified time limit the bitewings and pa’s may not be covered because the patient has exceeded their limit. There are (more)
asked 4 years ago by
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We are FQHC. One of our patient's needed clearance for an organ transplant. They originally saw a medical provider. That provider sent a request to our dentist asking for them to evaluate the patient to be cleared for the transplant. The patient made...
asw0929 May 18, 2022 11:24 am
I agree. D9310 would be the correct code for this service. D9310 consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician; A patient encounter with a practitioner whose opinion or advice regarding evaluation and/or management of a specific problem; may be requested by another practitioner or appropriate source. The (more)
asked 3 years ago by
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If a dentist sees a red or white lesion during a 150 exam and wants to re evaluate the pt in 2 weeks, is she/he allowed to use D0170 code? Will the insurance deny it? Thank you so much!
Zienab.k.elmalik January 23, 2022 9:57 am
Yes
asked 3 years ago by