Ask the Coder (563)

CDT code D9110 is typically inclusive of the extraction and therefor will be rejected when submitted at the same time as an extraction. As for the other code D01240 this code does not exist. If the code you were intending is D0120 that would be an inappropriate code as well, since the patient is coming (more)

You're stating that the insurance downcoded the procedure based upon the evidence of the perio chart? It would depend on if you are in network or out of network with the insurance company as to how they process the difference when they downcode the procedure. If you are in network, it's likely that they process (more)

It is very likely that the insurance is going to deny the second D9222 and D9223. I would submit medical records indicating the need for general anesthesia the second time (twice in a day). This is a rare occurrence, and it's likely that it will be denied as you already had the patient sedated once (more)

A prophy should not be billed out on the same day as scaling and root planing. The SRP should be preformed and a week or two later the patient should return for a prophy.

I'm sorry. I am not completely understanding your question. There is a big difference between the codes D0705, D0251 and D0274. D0274 bitewings - four radiographic images D0705 extra-oral posterior dental radiographic image - image capture only; Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that (more)

This question is to vague please give more detail...

Since the patient had 4 quads of SRP, the patient is a PM at that point. Just as an FYI, the first PM appointment is usually 90 days post SRP. So, for example, Delta is denying our D4910's within 90 days of SRP. This is a WRITE OFF. Not billable. Since it was NOT past (more)

You should use the standard medical form CMS-1500 when submitting any claim to Medicare. The code used should be 41899 for the extractions accompanied with the correct ICD-10-CM code. It would also be beneficial to send in the request from the oncologist requesting the extractions. Make sure you write in box 19 of the CMS (more)

Root tip removal should be coded using D7250 removal of residual tooth roots.

Since they are a requirement by some insurance companies on the CMS-1500 form I would say that it is also a good idea to enter them on the UB-04 form, but I cannot find documentation that states that it's a requirement. You might want to check with the insurance carrier to be sure.