Dental Coding Tip D0190 – Screening of a Patient
A pre-diagnostic screening, including state or federally mandated testing, determines an individual’s need to be seen by a dentist for diagnosis and care. Many questions have arisen regarding coding for services during the pandemic visits to the dentist were limited to emergency care only in some areas of the country.
There have been questions about whether this code D0190 is used to recoup the costs of extra PPE or time used to take the temperature of the patient before being examined by a licensed dentist. The answer is no, do not use this code.
Diagnosis and treatment of the patient are relegated to a licensed dentist in the state. Other medical or dental professionals may perform a dental screening. They act within the laws of their licensing, such as registered dental hygienists, mid-level provider, physician, or nurse. The dental screening involves a limited “look-see” with a tongue depressor to check for abnormalities such as injury, pain, bleeding, poor oral health care, mouth lesions, etc. Whatever the limited exam would reveal that would warrant further treatment or formal evaluation by a licensed dentist. Not all screenings result in referral to a dentist for additional care.
D1999 Unspecified preventive procedure by the report
D1999 is the code to use for reimbursement of extra PPE required during the COVID 19 crisis. It is a general preventive procedure that will vary in coverage from plan to plan. It is usually billed once per patient/claim and will have limitations on the amount and frequency of coverage.
- A note added to the patient’s record to document the PPE details used for the visit.
- 80 characters for the narrative are entered in the remarks section of the 2019 ADA Dental Claim Form.
- D1999 should be reported on a per-visit/claim basis
Every insurance denying d1999 code in ny state . Even send d1999 code with narrative it’s not covered procedure by most of ppo plan and government plan . Can you give any tips if you have success to get payment ??
Thanks for leaving a comment! I have found that some insurances are requiring a narrative as D1999 isn’t specifically for PPE reimbursement. I encourage you to submit a narrative if you aren’t doing that already. Other than that some carriers, regardless of location just aren’t providing a reimbursement. Hope that helps!