Ask the Coder (537)

Since they are a requirement by some insurance companies on the CMS-1500 form I would say that it is also a good idea to enter them on the UB-04 form, but I cannot find documentation that states that it's a requirement. You might want to check with the insurance carrier to be sure.

I'm sorry. I am not completely understanding your question. There is a big difference between the codes D0705, D0251 and D0274. D0274 bitewings - four radiographic images D0705 extra-oral posterior dental radiographic image - image capture only; Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that (more)

I found this on the webpage: https://www.dentalclaimsupport.com/blog/examining-cdt-code-d2940-do-you-place-protective-restorations-at-the-emergency-appointment#:~:text=The%20nomenclature%20defines%20D2940%20as%20a%20protective%20restoration.,outside%20the%20mouth%20then%20placed%20on%20the%20tooth This type of restoration is accurately documented and reported to the payer using code D2940 which was revised a few years ago. The previous code nomenclature defined this code as a sedative filling. The current code language includes a revised nomenclature and a descriptor. D2940 protective restoration Direct (more)

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)

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.

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)

There is not a separate code for toothbrush deplaquing. This service would be included in the prophy code, either D1110 (adult) or D1120 (child).

Yes it does because they are putting in a bridge or bridgework.

Did you submit the medical records for the necessity of the procedure? Be honest and open in your documentation - send medical records indicating the necessity of the procedure and a diagnosis to support what was done. You may want to also include a detailed letter that is descriptive of the necessity along with the (more)

D1206 Fluoride Varnish can be appropriate for any person no matter their age. That being said, most insurances will not pay for adults to have D1206. It is best to communicate to the patient they will likely be responsible for the cost of the D1206. There would be two reasons to apply D1206 to a (more)