Due to limitations within the CDT code structure, the concept of a Professional and technical fee has not gotten the attention it deserves. Unfortunately, anesthesia reimbursements and cases for medically necessary Dentistry, not OMF, are not payable under medical coverage. This is most prevalent with Pediatrics for Special Needs and Behavior Management Cases, where Payers generate huge savings from cases performed in-office rather than in ASC or Hospital settings.
I have reviewed every possible option within the CDT guide and industry reference material for a code that could be used for "Facility Fees". Dentistry has no coding to consider reimbursement of actual costs of performing surgical cases under General Anesthesia or Conscious Sedation like Medical coding. These actual costs of monitoring equipment, pre-operative clearance, and post-operative case management with nursing staff should be billable.
how many fillings is standard for dentists to do in one sitting?
This is for pediatric dental treatment under general anesthesia in an out patient clinic.
When billing D0251, should we bill 1 or 2 units of this because it's both the right and left side? And does it matter if it's for primary or permanent teeth?
I have a patient that has had SRP. He has been on perio maintenance (4910) for a year. If they have improved can they go back to an adult prophy (1110) or do they have to stay at a 4910? I was told once we use 4910 they have to stay with that code.
I have to submit to submit a section of bridge to Medical. Is there a CPT code?