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When we bill for an exam (ex: 99214) to medical .. if it is denied, how do I go about then billing dental (0160)? Does everyone go back into their software system and change the code? That seems messy for all types of reasons.
Same with pano(s) D0330 ADA code vs. 70355 and any other service that has 2 different codes between dental and medical.
Thank you!
Jill T.
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Hi Jill!
Great question - and yes typically you would need to change the code to the corresponding ADA code in order for the dental insurer to be able to process the claim.
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Thanks Courtney, What do offices use as alias/dental code to the 99213 or 99214 code? 0160 feels most appropriate. Thoughts?
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Hi Jill!
I have seen many offices use exactly that (D0160) to accommodate in their dental practice management software, if it does not have the ability to store & use CPT codes. Some other common ones i have seen used:
D0120 - periodic oral evaluation - established patient
D0140 - limited oral evaluation - problem focused
D0150 - comprehensive oral evaluation - new or established patient
D0160 - detailed and extensive oral evaluation - problem focused, by report
D0170 - re-evaluation - limited, problem focused (established patient; not post-operative visit)
Hope this helps!
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