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When the doctor notes two separate areas of decay on a single tooths O surface, for example spotting decay on a molar tooth and the doctor calls out "O, and OL", how should we file this? Similar situation when there is decay on the O, and the doctor wants to seal up the groove and completes a connected OL & OB composite. Should it be filed this way, as two - two surface fillings or is it a 4-surface filling? Or should it just be considered an O filling, even if the doctor fills any remaining L or B grooves? We had a lot of confusion on this!
Admin July 29, 2011 9:04 am
If the filling is solely on the Occusal surface it is considered a 1-surface filling regardless of the location of the decay. Example: If the doctor drills into the occlusal surface and the lingual surface of the tooth then it would be considered a 2-surface filling, if he drills into the occusal, lingual and buccal (more)
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Another question about code D9951 (Occlusal Adjustment - Limited). If the doctor does both upper and lower adjustments in one visit, should it be entered twice or does this code cover upper or lower as well as upper and lower? Thanks!
Admin June 23, 2011 7:46 am
This code is to be used on a per visit basis, some carriers will allow for it to be billed per quadrant while others consider it to be a one time billable charge. You need to review your carrier contracts for exact usage.
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I need more clarification on Code D9951 (Limited Occlusal Adustment - Limited) I see in my ADA CDT book it states it is not supposed to be used when the procedure is for a bite adjustment when doing it post-delivery of something such as a crown/bridge. Is there another code to use when the doctor adjusts the bite after delivery or should it relate with another code? Thanks!
Admin June 22, 2011 8:27 am
According to coding guidelines an adjustment done post delivery of a crown or bridge is included in the original fee and is not billed seperately, unless the adjustment is being done more than 30 days after the initial delivery.
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I am new to orthodontic and dental billing. The patient may have a 27-month or 30-month treatment, but our office likes to have the bill paid in 24 months. So the private pay part is divided up, % down and 24 monthly payments. In submitting claims for insurance, I have seen others put in the number of months of treatment remainnig (box 42 J400) accurately as 27 or 30, but then put the code, total case fee, initial banding fee, and something like "24 months to be billed at $____ per month." Is it okay to bill insurance this way?
Admin June 19, 2011 1:51 pm
You always want to fully disclose to the insurance company how a contract or treatment is being proposed or paid for by the patient. Yes, it is ok to bill this way!
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I need to find out how to code for 3rd molar extractions on the CMS-1500 claim form.
Admin January 1, 1970 12:00 am
Third molars are coded in box 24 D of the CMS form It should look like this: 41899 UL 41899 UR 59 41899 LL 59 41899 LR 59 The UL, LL, LR & UR are placed in the first modifier field, the 59 is placed in the second modifier filed and is appened to the (more)
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what is the best icd 9 code for an amalgam tattoo?
Admin May 11, 2011 10:06 am
The code is located by going to the alphabetic index and looking up the main term Discoloration, from there you will look up the subterm mouth and it give you ICD-9 code 528.9
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Filing a medical claim. CPT 21040 ICD-9 526.0, the doctor grafted the defect using code 21215. I am not sure what modifier to use, he also did this procedure under IV anesthesia 3 units of 00190.
Admin May 5, 2011 9:08 am
This procedure does not require a modifier as the 21040 (excision of benign tumor or cyst of mandible, by enucleation and/or currettage) and 21215 (Graft, bone, mandible/including obtaining graft) are seperate procedures. You may append modifier 51 however it is not necessary in this instance.
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i just signed up for membership of adca and would like to get the 25% discount on my isp study program…Do I get this coupon code from you?
Admin May 2, 2011 9:17 am
This forum is for coding questions only. Please contact technical support for any book or class related issues. support@adcaonline.org
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Greetings - I have 2 questions 1. I am trying to take the Module 1 practice exam but I am unable to log in with my ADCA username and password. do I need to set-up another one? 2. I have 2 dental billers in my office and I would like to register them as members so that they can take the certification exam,also. Is there a way that I can do this for them and pay the fee through our organization?
Admin April 28, 2011 7:46 am
In regards to your first question about the practice exams, you need to follow the instructions in your book. Step one: log onto to the website indicated in your book Step two: in the top right corner click on the "Register Now tab" Step three: register yourself with a user name and password As for (more)
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My pt is 24 years old (DOB 12/26) and lives at home, she has her own policy through MetLife Dental and her mother (DOB 12/27) has a policy through Delta Dental. I want to confirm that her policy is primary and mothers is secondary. Is this correct???
Admin April 22, 2011 4:34 pm
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.
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