Is D0476 covered by insurance?

Coverage for D0476 can vary by insurance provider. It's important to check with the patient's insurance for specific coverage details and requirements.

Can D0476 be used for any type of specimen?

D0476 is typically used for biopsy or surgical specimens where additional staining is necessary to identify microorganisms.

How does D0476 differ from standard staining procedures?

D0476 involves the use of additional, specialized stains that target specific microorganisms, unlike standard stains which may not reveal certain pathogens.

What documentation is required to support the use of D0476?

Documentation should include clinical indications, specimen details, initial staining results, and the pathologist's interpretation of the special stains.

D0476

Special Stains for Microorganisms - CDT Code Guide

Diagnostic/Oral Pathology Laboratory

Overview

CDT code D0476 refers to the application of special stains to biopsy or surgical specimens to identify microorganisms. This diagnostic procedure is crucial in oral pathology laboratories, where precise identification of microbial presence can guide treatment decisions. The process involves applying additional stains to specimens, which can highlight specific microorganisms that are not visible with standard staining techniques. This is particularly important in cases where infections are suspected, and accurate microbial identification is necessary for effective treatment planning. Dental professionals rely on this procedure to ensure comprehensive diagnostic evaluations, especially in complex cases involving oral infections.

When to Use This Code

When a biopsy indicates the presence of an infection and further identification is required.
In cases where standard staining does not reveal sufficient information about microorganisms.
When a patient presents with persistent oral infections and a detailed microbial analysis is needed.
For surgical specimens where infection is suspected but not confirmed.
In follow-up evaluations of previously diagnosed microbial infections.

Documentation Requirements

Detailed patient history and clinical indications for the procedure.
Description of the specimen type and site of collection.
Results of initial staining procedures and rationale for additional staining.
Identification of specific microorganisms found, if applicable.
Pathologist's report and interpretation of findings.

Billing Considerations

When billing for D0476, ensure that the procedure is justified by clinical necessity, as insurance may require documentation of the need for additional staining. Frequency limitations may apply, and it's important to verify with specific insurance policies. Common modifiers include those indicating multiple procedures or complex cases. Ensure that all documentation supports the use of this code to avoid claim denials.

Related CDT Codes

D0480 D0417 D0418 D0472 D0473

Frequently Asked Questions

Special stains are used to identify specific microorganisms in biopsy or surgical specimens, which can aid in diagnosing infections and guiding treatment.

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