Codes Flashcards
What x-ray codes often share frequency?
Panoramic (D0330) and Full Mouth Series (D0210)
What is the code for 4 Bitewing Xrays?
D0274
What is the code for 2 Bitewing Xrays?
D0272
What are some procedures that may have age limitations?
Sealants- D1351
Fluoride D1206, D1208
Orthodontic Treatment D8090
What is the code for a panoramic?
D0330
What is the code for an adult prophy?
D1110
Does the deductible usually kick in at the debridement appointment?
Yes
What are some restrictions that sealants may have?
- Age restriction
- May not be covered on premolars
- May be covered only once/lifetime
What is the difference between D1208 and D1206?
D1206 is a fluoride VARNISH
D1208 is a fluoride gel
Fluoride varnish is usually covered for kids up to age 5
Can all 4 quadrants of scaling be completed the same day?
Typically NO. usually only 2 quadrants can be completed at the same time
Please explain an alternative benefit
The insurance reserves the right to select the least costly option to restore the tooth. Even if the material is not selected they will reimburse of to the cost of the more affordable option
A patient has an implant placed. What are the codes you need to verify when treatment planing?
D6057
D6058
What percentage is ortho usually covered at?
50%
What is the code for an FMX?
D0210
Which Insurance company often does not cover PAs (D0220)?
United Health Care
Name some insurances that fall under DHA
United Concordia -some plans
Mutual of Omaha
Sunlife
Restorations start with what number?
D2 (TWO)
A patient states they have Deltacare. Are we in network with this plan?
NO. Deltacare is an HMO plan
Name some insurances that follow the Connection Dental Fee schedule
Connection Dental/GEHA
Aetna/Principal (Dr. Felder only)
BEAM
Blue Cross Blue Shield of Alabama
Dental Benefits Provider (UHC)
Guardian
GEHA
Golden Rule
Lincoln Financial Group
What is a TPA?
A third party agreement that allows insurance companies to lease other networks. This provides a larger provider base for patients
Is whitening generally covered by insurance?
No. Whitening or external bleaching is generally NOT a covered benefit
