Ask the Coder (559)

You can certainly charge out radiographs with restorations. You have to be mindful of the plan limitations set in place by the carrier. If a patient has had a full mouth series done within a specified time limit the bitewings and pa’s may not be covered because the patient has exceeded their limit. There are (more)

By report means you must send in a dictated report from the dentist on the procedure and how it was preformed, along with the claim submission.

I would not send a narrative for this procedure, but the very detailed clinical documentation stating the necessity of the procedure. Unless the patient has implant coverage with their insurance carrier, in most cases the procedure is likely to be denied. Therefore, indicating the need to send as much documentation as possible IF the procedure (more)

Medical cross codes for examinations are based off documentation, there is no way to cross code this without seeing the documentation in the chart please refer to your CPT coding manual to select the most appropriate code; Examination code ranges: New patient 99202-99205, Established patient 99212-99215 As for the rest cross codes are as follows: (more)

CEU's are not required. Just maintain your membership to keep your certifications in good standing

Well truly, medical should be billed first. Also, the answer is going to depend on if the service is covered under the patient's medical plan. Since it's a pano or bitewing... it's likely that it will not be covered medically. If it is... be sure that you have a good medical diagnosis to support the (more)

D2980 crown repair necessitated by restorative material failure A repair to a crown because the material used to make the crown cracked, chipped or broke.

The problem here is fax back eligibility does not guarantee payment from the carrier it merely states to the best of their knowledge the patient is active and eligible for treatment under the plan. You may try to appeal this decision by refiling the claim and sending in fax back proof of eligibility at time (more)

No. A tooth number is not required for this code, as this service is not pertinent to a tooth. D7410 is the excision of a lesion from the inside of the mouth. The length of the lesion is required in order to select the code, however. D7410 excision of benign lesion up to 1.25 cm

Hi, Which are you submitting? The missing tooth or the crowns?