Wiki Annual Re-exams for OAT for OSA

lafael03

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Escanaba, Michigan
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I need help with diagnostic coding for an annual follow-up. Doctor fabricates oral appliances for obstructive sleep apnea (E0486). The initial visits are included through the titration of the appliance. Periodically (typically every year), they come in for an exam to keep the warranty valid. We have been coding a 99212 with a diagnosis of G47.33 followed by Z12.81.

The trouble I'm having is the secondary code. Through previous courses on "advanced billing of the dental practice for cross coding," doctor also wants it considered a screening for oral cancer. Would the Z12.81 code be needed, or is this just something understood as inclusive of the 99212? What are the guidelines with Z12.81 as a secondary code? From the course, I understood that with supporting documentation, it is for a visible or a Velscope screening for prevention of oral cancer. What would it hurt to include?

This has been a stressful process with the 3rd party billing company and I'm hoping for resolution. Thank you for your input!
 
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