You’ve charted and completed bitewings (D0272 / D0273 / D0274) and a pano (D0330) for your patient, along with a few other procedure codes. You’ve submitted your claim, and you finally receive the insurance payment.
But what’s this? The insurance paid on a different code. They’re paying based on a Full Mouth X-Ray (FMX) code (D0210) instead of the procedures you charted. Now what?
Here’s our recommendation.
- First, you’ve charted and set complete the procedures that were done, so there is no need to delete these or re-chart anything else. It is fairly common for an insurance company to “remap” a submitted code(s) to another code for payment purposes. That does not change the charted procedures that were determined by the dentist to meet the needs of the patient.
- Allocate the insurance payment appropriately across the multiple codes you charted.
If you’re receiving payment of $150 for the FMX and the charted xray procedures are for $60 and $100 for example, make sure to allocate payment accordingly so you don’t create an insurance over-payment on any one procedure code.
- Put a note in the “Remarks” column that the insurance paid based on FMX code D0210. This will leave a record of how insurance paid, and if needed, prompt a look at the EOB.
- Finalize the payment as usual, scanning your EOB to attach it to the check.
Questions about this process? Give us a call – we’re here to help!