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D4355 Code after D0150
Last Post 5/30/2012 8:05 PM by Shanangee. 0 Replies.
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Shanangee
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5/30/2012 8:05 PM
    My explanation of Benefits from Insurance Company showed I was billed for D4355 - Full Mouth Debridement. Research is telling me that something is incorrect in the order of events that the dentist billed for. Research seems to stress that the order of the procedures is important for reimbursement purposes.

    Visit 1 - Comprehensive Oral Evaluation (D0150) and Complete X-Ray Series (D0210)

    Visit 2 - Full Mouth Debridement (D4355)

    Is the order procedures important for reimbursement to ME or to the DENSTIST? Is it something that I should bring to the attention of Insurance Company to make them aware of the habits of this dentist? Admittedly, I am afraid that making a "stink" will somehow end up negatively affecting me.

    Insurance Company covers 80% of D4355 instead of the 100% that would have been covered for a standard cleaning. My initial irritation was that they performed something "above and beyond" without giving me a good idea that I may not be covered by insurance.

    - On a Budget and Ruthless.
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