Due to limitations within the CDT code structure, the concept of a Professional and technical fee has not gotten the attention it deserves. Unfortunately, anesthesia reimbursements and cases for medically necessary Dentistry, not OMF, are not payable under medical coverage. This is most prevalent with Pediatrics for Special Needs and Behavior Management Cases, where Payers generate huge savings from cases performed in-office rather than in ASC or Hospital settings.
I have reviewed every possible option within the CDT guide and industry reference material for a code that could be used for "Facility Fees". Dentistry has no coding to consider reimbursement of actual costs of performing surgical cases under General Anesthesia or Conscious Sedation like Medical coding. These actual costs of monitoring equipment, pre-operative clearance, and post-operative case management with nursing staff should be billable.
how many fillings is standard for dentists to do in one sitting?
This is for pediatric dental treatment under general anesthesia in an out patient clinic.
When billing D0251, should we bill 1 or 2 units of this because it's both the right and left side? And does it matter if it's for primary or permanent teeth?
We did a sinus lift on the UR and UL. Can I only bill the 7951 once or can I bill it for the UR and again for the UL?
Can a D6080 code be used for locator dentures that can be removed by the patient or only fixed appliances?
We no longer take impressions or diagnostic casts. Is there a CDT code that would cover the intraloral scan with our Itero when we are preparing a treatment/case work up for an Invisalign consult? Can we still bill out D0470 or do we use D0393?