Ask the Coder (544)

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!

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)

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

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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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)

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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Shoeing the cusp is merely shaving a projection of the masticating surface and would not be considered a fourth surface. Therefore billing for a 4 surface restoration would be incorrect. A more appropriate way of coding would be to code the three surface restoration along with D9551 occlusal adjustment for the shoeing, as long as (more)

Please visit our forms section in your members dashboard for a generic template on medical necessity. Simply fill in the blank areas to support your reasoning for "medical necessity." As each patient's needs for treatment are different I cannot give you the reason for medical necessity, there must actually be medical necessity for the treatment.