Medical Billing Forum

Billing => Billing => Topic started by: Scott on March 14, 2016, 05:37:39 PM

Title: Dental Billing for Cone Beam Scans
Post by: Scott on March 14, 2016, 05:37:39 PM
Hi all.  Does anyone know how dentists bill medical insurance for cone beam scans and what the typical billing rates for medicare and private are?  Thanks
Title: Re: Dental Billing for Cone Beam Scans
Post by: Michele on March 15, 2016, 01:11:57 PM
If it is medical it is submitted on the CMS1500 (rev 02-12) form, or 837 format if electronic.  Medicare allowed amounts are available on their websites.  Private fees are not usually available.  You need to develop a fee schedule for the services provided.  Many use the Medicare allowed amount as a gauge and bill based on that.  For example if the Medicare allowed amount is $100 for a certain service, then you may choose to have a fee of $140 for that service.  Then adjust off any amount that is disallowed as over the contracted rate (if you are in network).
Title: Re: Dental Billing for Cone Beam Scans
Post by: Scott on March 18, 2016, 10:09:22 AM
I appreciate your help Michele.  We couldn't find cone beams priced in Medicare.  Have you had any practice billing cone beams to Medicare?  Do you know if they have an allowed amount for these specific codes D0364-8?
Title: Re: Dental Billing for Cone Beam Scans
Post by: Michele on March 21, 2016, 12:45:35 PM
I do not have experience in that.  The D code is a dental code.  You need to find the appropriate CPT code for your service if it is a medical service.  In order to bill medical insurance on the CMS form you have to have a CPT code, you can't use the dental code.