Wiki Hcpc d codes for dental in asc

GLORIAR

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Are you aware that the D codes are no longer in the HCPC? Does anyone bill Dental for ASC facility? Are you using HCPC D codes? According to BCBS of MN all ASC's should bill on the professional electronic claim format as of 07/01/09. BCBS MN will deny all ASC claims on an institutional format. Now we are getting denials from BCBS for using the invalid HCPC procedure code in professional service. Any input would be nice.:(
 
I bill HCPC D codes for dental in an ASC in Florida. However, we have never billed any D codes to any commercial carrier as they will be denied.

Here in Florida we do have a state statute that requirs commercial carriers to cover dental procedures in outpatient settings for children with medical necessity. Although the statute provides coverage for children, we are finding that commercial carriers vary in the age limitation. We are finding that BCBS will cover a child up to the age of 8. In most of our dental cases, we have been billing with the unlisted dental procedure code 41899.

Our Medicaid cases are much easier. We have been advised to bill using D9420 as that is the only code Medicaid will cover here in Florida. As Medicaid is different in each state, you may want to ask your local Medicaid Provider Liason.

Hope this info was somewhat helpful.
 
Oh also for the lack of D codes in the current HCPC..I noticed that it explains in the changes section that Ingenix removed the D codes due to copyright issues with the American Dental Association. You can still get the D codes but you have to buy them separately through the ADA.
 
We use D7220-D7250, they havent been deleted. Our commercials pay and so does bcbs/aetna. We also use the unlisted 41899. We always get paid with these two codes. Thanks.
 
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