D9110 is a misunderstood code as many offices code D0140 for emergency visits when treating a patient for pain or discomfort.
Using D9110 vs D0140
D0140 is an evaluation code and is limited to the “one evaluation per six months” or “two evaluations per year” rule. Consider reporting D9110 for minor procedures to reduce discomfort, sensitivity, or pain at an emergency visit. D9110 is a procedure code and will not use one of the exam limitations. When reporting D9110, include the required narrative. Palliative D9110 should not be used in conjunction with a definitive procedure such as a filling or extraction.
If you are struggling with dental codes consider partnering with eAssist. Our Success Consultants are familiar with the various CDT codes and will ensure they are billed correctly. To learn more, schedule a consultation here.
Avenue 17
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Robertbroab
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Gregory Charles Narez
Question. Had tooth #32 gave me an occasional jolt. Went to Dentist #1 in May, and they could not determine which tooth (freeze, tapping, etc) thought 31-or 32 I used a frozen cut tip and thought I figure which one it was. Three weeks later back to dentist #1 again said it was either 31-32, but did not know for sure. Sent me to a specialist dentist #2. I spent $375 for evaluation minus $200 from insurance. They said they thought it was probably #32, and either needed a crown and/or replace filling. Back to dentist #1, says will need a crown. So they put code D0140 ($ 46) on each visit, and insurance was paid once. Why am I charged for code 0140 added on to the $900 crown price? They charged me that code three days earlier, when he said the filling was too large to replace and they gave me a price to come back three days later for a crown They already know they are doing a crown and there is no evaluation involved. I asked, and they said anytime the Dcctors see me, there is a D0140 code.
Brandy Davis
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Tara
What prices are you guys using for this? Not even sure if insurance covers this… But we need a self pay price too.
Anne D
why is it that the insurance won’t pay on D0140 when other services, besides x-rays, are rendered in the same visit? I went in for a broken tooth, had an x-ray, and they decided to fit me for a crown. why would I go in for an evaluation and not take corrective action? can I appeal the denial with success?
Jaycee Brown
eAssister Jackie has an answer for you Anne!
“Unfortunately that’s most likely a part of your insurance plan processing policy. The insurance provider is the one who writes those rules, and I have not personally had success with overturning those types of denials. But if you are wanting to appeal it, you can always write up the department of insurance about it and complain!”
wally schatz
can you bill d0140 and d9110 in same visit or will insurance only pay one
Jaycee Brown
Hi Wally, our awesome eAssister Estela has an answer for you! “For D9910 it is dependent on the patient’s policy. Some plans will pay exam on the same visit, others will not.”