Answers
Question
If I send a claim to a primary insurance and they pay a portion and have a contractual adjustment that covers the remaining portion of the balance leaving no patient balance, is it appropriate to send the claim to the patients secondary insurance hop...
Austinida April 8, 2025 2:15 pm
Hello! The patient's secondary insurance always needs to be billed to ensure accurate procedure history, regardless of the amount of the primary insurance's payment. Hope this helps!!
asked 10 months ago by
What is the code for the visit between extraction and dental implant
JLOUD April 8, 2025 1:34 pm
D0171
asked 9 months ago by
If I treat a patient for scaling in one to three teeth code 4342 and all four quadrants will the patient's insurance company allow for a D 4910 for maintenance every three months
AR April 7, 2025 3:54 pm
Hello! This is a great question. For D4910, each insurance plan is different. If the patient has coverage for D4910, typically, the insurance will want the date of the initial scaling and root planing along with x-rays and perio charting less than 12 months old. When it comes to the perio maintenance frequency, that also (more)
asked 3 months ago by
Can you bill for D9223 if less than 15 minutes additional sedation was completed? For example, if 20 minutes of sedation was done can you bill both D9222 and D9223? Thanks.
Austinida June 16, 2025 8:14 am
Hello! D9222 and D9223 are billed specifically in 15 minute increments, so if it is under 30 minutes, it is not recommended to bill for both D9222 and D9223 (total of 30 minutes) if only 20 minutes of sedation were performed.
asked 1 month ago by
CAN I SENT A DENIAL TO THE MEDICAL CARRIER FOR PAYMENT WHEN A DENTAL CARRIER DENIED FOR FREQUENCY (PANO OR BIWINGS).
asw0929 May 16, 2022 7:44 pm
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)
asked 4 years ago by
Anonymous
cdt for antibiotic prophylaxis
Enter your nickname February 10, 2025 6:37 am
katana
asked 3 years ago by
A patient presented with chief complaint of pain on a single tooth. I evaluated the tooth and took an xray/PA. I did not do any treatment that day. Was I correct to use D0140 and D0220 for the appointment? Or should I have used D9110?
RCM Expert November 16, 2022 11:20 am
D9110 is for an emergency palliative treatment. D0140 is to exam a problem focused area. Usually D9110 is for a same day emergency appt and you may only exam, take an X-ray, prescribe Rx or an open and drain to alleviate immediate pain. If this was an appt set up a week or days in (more)
asked 3 years ago by
I've never submitted to medical and don't have claim forms
asw0929 April 14, 2022 2:42 pm
In order to bill medical insurance, you would need to contract/use an online company to bill medically or purchase a stack of CMS-1500 forms and complete the forms in your office to send to the insurance company. You would also need to be sure that you have a CPT code book and ICD-10-CM code book (more)
asked 3 years ago by
There are no restriction to bill these two codes together for the same DOS. However, you want to make sure you are include supporting documentation as to why you performed both procedures on the same day and the time involved. Make sure to include ch...
Meg April 9, 2025 6:39 am
Can you bill a pro on one day of service for the initial visit and then ask the patient back for an SRP and bill out SRP on another day of service? Also, is there any restriction on time on when to bring the patient back for SRP after the apro? An established patient came (more)
asked 2 years ago by
i was told you should always take only the primary adjustment but was always taught to take the higher amount. which is it?
medaudsolutions April 8, 2025 3:17 pm
What is the secondary changed their fees/policy? If 100 allowed, primary paid 80, then I would transfer the $20 to the secondary, let the secondary adjudicate then make my adjustments. I am not saying balance bill. The primary allowed 100, I would transfer up to that just like EOB says to secondary. You could be (more)
asked 6 months ago by
