Ask the Coder (163)

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)

D9630: drugs or medicaments dispensed in the office for home use; Includes, but is not limited to oral antibiotics, oral analgesics, and topical fluoride; does not include writing prescriptions.

Today we began treatment on a patient to replace PFM crown with new one. After the old crown and decay was removed (75mins into the appointment) it became clear that the tooth was non restorable and was referred for extraction. What code can we bill for the time spent in the chair? what code to (more)

Need more information. One is a crown code and one is a space maintainer. You always bill for what you do so I’m not sure what you are asking?

CDT 9987 reports a cancelled appointment. The CDT description does not indicate whether or not the procedure has been cancelled by the provider or patient. If you are not using the code to charge a fee for cancelled appointments, then it would be appropriate. Of course the notes should show why the appointment was cancelled. (more)

Suture Removal would only be charged for if your provider did not place them. Otherwise, they are included in the procedure that required them.

You need to check your insurance contract and fee schedule limitations for that particular insurance. Typically, insurance will not cover a D0140 and D1110 the same day but it depends on the contract. Hope this helps!!

D4212 is to be used when you need access for a restorative procedure such as crown or filling. This is not to be used to remove large pockets in gum tissue. Whitout reviewing the providers notes of treatment performed we may suggest that If RPS was performed a more appropriate code for removal of large (more)