Ask the Coder (539)

The CDC exam uses ICD-10-CM code sets

If a patient has been seen in the office in the past 3 years by any provider in the practice they are considered an established patient. It does not matter if you are billing medical or dental. To answer your question specifically you would use and established patient E/M code,

Yes they may bill the D code to medical as there is no compatiable CPT code for fluoride varnish. As for reimbursment of this procedure to medical providers there is no statistical data to prove one way or the other as of yet. It is completely upto the individual carriers.

No, you may not bill this to the insurance. Coding guidelines clearly state topical flouride varnish must be delivered under the direct supervision of a dental professional and delivered in the dental office.

In dentistry, an inlay is an indirect restoration (filling) consisting of a solid substance like gold or porcelain and is fitted directly to a cavity in a tooth then cemented into place. An onlay is the same as an inlay, except it extends to replace a cusp. So to answer your question, yes, if it (more)

Fluoride codes have changed for 2013, the following are the only fluoride codes to be used. All other fluoride codes have been deleted. 1. D1206 - to be used on both child/adult when a fluoride varnish has been applied 2. D1208 - to be used on both child/adult when topical fluoride has been used (i.e. (more)

Yes, the patient's policy should be primary. There would be only one exception if both carriers abide by the policy that has been in effect the longest then the mother's policy would be primary.

Usually this would be considered an inclusive part of the original procedure and is not billable. However, you may try billing D9999 and include a brief narrative for consideration.

All diagnosis made for the patient should be noted in the chart, the ICD-9-CM codes do not need to be billed on the ADA2006 claim form.

The answer depends on if the hygienist is an affiliated dental hygienist or a registered dental hygienist...without this knowledge an appropriate answer cannot be given,