Consultation Service - CDT Code Guide
Overview
CDT Code D9310 refers to a consultation service provided by a dentist or physician other than the one who initially requested it. This code is used when a patient is referred to another practitioner for their expert opinion or advice on the evaluation and management of a specific dental problem. The consultation includes a comprehensive oral evaluation and may lead to the initiation of diagnostic or therapeutic services by the consulted practitioner. This service is crucial in cases where specialized knowledge or a second opinion is necessary to ensure optimal patient care.
When to Use This Code
- When a general dentist refers a patient to a specialist for a second opinion on a complex dental issue.
- In cases where a patient requires a specialized diagnostic evaluation not available from the primary dentist.
- When a physician requests a dental consultation for a patient with oral health concerns impacting their overall health.
- For interdisciplinary cases where multiple healthcare providers are involved in a patient's care plan.
- When a patient seeks a second opinion before undergoing a major dental procedure.
Documentation Requirements
- Referral documentation from the requesting dentist or physician.
- Detailed notes of the consultation, including findings and recommendations.
- Documentation of the oral evaluation performed during the consultation.
- Any diagnostic or therapeutic services initiated as a result of the consultation.
- Patient consent forms, if applicable.
- Correspondence or communication with the referring practitioner.
Billing Considerations
When billing for D9310, ensure that the consultation is not billed in conjunction with other evaluation codes on the same date of service. Check with insurance providers for any frequency limitations or pre-authorization requirements. Common modifiers may include those indicating a separate and distinct service. It's important to verify coverage with the patient's insurance plan, as some may have specific guidelines for consultations.
Related CDT Codes
Frequently Asked Questions
No, D9310 should not be billed on the same day as a routine check-up or other evaluation codes.
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