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    If x-ray were not diagnostic, do we still charge for them?
    Admin 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.
    Admin
    asked 14 years ago by
    ADCA Admin
    1
    answer
    0
    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?
    Admin 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.
    Admin
    asked 14 years ago by
    ADCA Admin
    1
    answer
    0
    Do you have a sample of an appeal letter for a denial for treatment that had been given prior-authorization?
    Admin 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.
    shaunadasilva
    asked 14 years ago by
    Shauna DaSilva
    1
    answer
    0
    If single bitewing was taking, can it be charge out as a PA?
    Admin September 28, 2011 6:53 am
    No, it should be billed as a single bitewing CDT code D0270
    Admin
    asked 15 years ago by
    ADCA Admin
    1
    answer
    0
    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?
    Admin September 22, 2011 10:05 am
    A follow-up visit after extractions is not billable, it is considered inclusive of the primary procedure.
    Admin
    asked 15 years ago by
    ADCA Admin
    1
    answer
    0
    We are having trouble getting our pano(D0330) and bite wing(D0272 or D0274)paid when they are performed on the same day of service. If we took Pano, BWs and additional PA's can we code as FMX? Is there any other way of coding these services in order to receive payment? Thanks
    Admin September 22, 2011 8:11 am
    A full mouth series usually consists of 14-22 periapical and posterior bitewing images that are intended to display the crowns and roots of all the teeth. Since a panoramic film is not intraoral it would not be appropriate to code this as a full mouth series. You will need to seperate out the codes, if (more)
    Admin
    asked 15 years ago by
    ADCA Admin
    1
    answer
    0
    My PT is getting a conventional overdenture. In order to prepare the remaining natural tooth structure to rest under the denture, the doctor must file away the natural tooth crown so only the tooth root remains. Then he must cap the root with composite material. He called the procedure a "root cap." What are the proper CDT codes to use for insurance billing purposes?
    Admin September 21, 2011 1:10 pm
    Since the procedure described "file away the natural tooth crown" does not fit with coronectomy D7251 you must use an unlisted oral surgery procedure code D7999. The "root cap" does not have a specified code either, therefore your choices are D2940 if the restorative material is temporary, D2999 unspecified restorative procedure, by report if the (more)
    Admin
    asked 15 years ago by
    ADCA Admin
    1
    answer
    0
    My patient wants a full denture. The patient wants to keep just one tooth root and remove the tooth crown. Should I code the denture as an overdenture? The dr. needs to file down the crown so only the root is left. He then plans to place a layer of composite over the top of the tooth. How should I code these procedures?
    Admin September 21, 2011 12:49 pm
    If the dentist plans on attaching the denture to the roots or implants then the answer is YES! You would code this as an overdenture. D5860-D5861
    Admin
    asked 15 years ago by
    ADCA Admin
    1
    answer
    0
    We refer patient to a Oral Surgeon, they pulled tooth out and put sutures. Patient came to our office to remove sutures. What code should we use? Since we did not pull his tooth but remove his sutures. Thank you
    Admin September 21, 2011 9:17 am
    Since there is no specific code for suture removal you would use D7999 (unspecified oral surgery procedure, by report). You will need to send a short narrative along with the claim explaining what was preformed.
    Admin
    asked 15 years ago by
    ADCA Admin
    1
    answer
    0
    We are having trouble getting our pano D0330 and bite wing D0272 and D0274 paid when they are performed on the same day of service. Is there any other way of coding these services in order to receive payment? Thanks
    Admin August 24, 2011 11:00 am
    Unfortunately you are not able to code this as a full mouth series because there are no PA films included. If you are taking a pano and six bitewing films, you are limited as to coding. The way you have coded this is appropriate and correct. If the carrier is not paying on this claim (more)
    Admin
    asked 15 years ago by
    ADCA Admin
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