Ask the Coder (536)

No, dental carriers do not require the use of diagnosis codes when processing claims.

Medicare is never automatically the primary insurance carrier for any state, you must determine what coverage the patient has and determine who is the primary carrier. Let's say for example the patient has a working spouse with crediable coverage through Cigna, in this instance the patient's primary carrier would be Cigna and Medicare would be (more)

There is no such code as D6078 your choices for the abutment supported fixed denture would be D6075-D6077 depending on the type of material you are utilizing (example porcelain fused to metal, cast metal or ceramic). You will further want to bill for the connector bar using CDT code D6055 and any pre-surgical services such (more)

The rules to billing medical carriers are defined within your contracts and vary from carrier to carrier, you need to review your contracts or review the guidelines found in your CPT manual. As for determining diagnosis codes these must come from your doctor, you as a coder/biller may not determine what diagnosis is appropriate. Once (more)

The appropriate code for the extractions would be 41899 with the use of modifiers, so your claim would look something like this; 41899 UL 41899 UR 59 41899 LL 59 41899 LR 59 The modifiers UR, UL, LL, LR indicate the quadrant, while the modifier 59 alerts the carrier that these are seperately identifiable procedures (more)

Since this is a problem focused exam and only a follow-up the appropriate code would be D0140. If this was the initial visit for the appliance the appropriate code would be D0160.

The difference is quite simple CDT code D1203 Topical Fluroide is used for children who are not at a high risk of developing caries. While CDT code D1206 was created for patients who are at moderate to high risk of developing caries due to systemic disease, medications they are taking or other conditions. You should (more)

The only CPT code available at this time is the unlisted code 41899, you should utilize this code along with ICD-9-CM code 520.1 for (Supernumerary teeth).

D7951 is used for augmentation of the sinus cavity to increase alveolar height for reconstruction of edentulous portions of the maxilla. It includes obtaning the bone or bone substitute. Most common diagnosis code for this procedure would be 525.25 (moderate atrophy of maxilla) or 525.26 Severe atrophy of maxilla. If the doctor was placing an (more)

I have not reviewed the book personally, however, PMIC is a great company. I do know that they have backing from the AAOMS for the book so it must hold some validity.