Wiki Help with E/M coding question!!

[brennaraine]

I work for an oral surgery practice. We have a patient who needs to have her teeth extracted in the hospital due to an extensive medical history. Her insurance does not cover the extractions at all. We are trying to get the insurance to cover the hospital portion of the procedure. We usually use code D9420 when taking a patient to the hospital, but her insurance will not accept this. If we are not admitting the patient, what CPT code would we use?

 

[luz.buenaventura]

First, determine the type of insurance before billing the claim. Does the patient have medical or dental insurance? If billing for medical insurance, it would be safe to use CPT codes. If billing for dental insurance, CDT codes should be used. I work for an Oral Surgery Teaching Hospital and it truly is a unique department in terms of coding and billing.