Wiki Dental Pre Op billing and coding

[Kuchersatx]

I work at a pediatric office and we see children sometimes for Dental clearances, but they keep getting denied for diagnosis code or inappropriate use of modifier. we use it as a sick visit with a 99213, dx code is z01.818 with a 23 modifier. Does anybody have any advice or experience with this type of claim?

 

[csperoni]

The E/M would be whatever level was appropriate and documented (99202-99215). The dx Z01.818 also sounds correct for medical clearance.
Your modifier -23 is definitely incorrect. That is an anesthesia modifier with the exact description of "unusual anesthesia." I'm guessing that's the root of your problem.

 

[Kuchersatx]

Thank you so much for your advice.