Consultation on Slides - CDT Code Guide
Overview
CDT Code D0484 refers to a specialized diagnostic service where a dental professional evaluates microscopic slides of a biopsy specimen that were prepared at a different laboratory. This service is crucial in providing a second opinion or aiding in the diagnosis of complex or challenging cases. Typically, a pathologist or oral pathology specialist will review the slides and deliver their findings in a comprehensive written report. This code is particularly useful when a patient or referring dentist seeks additional expertise to ensure an accurate diagnosis, especially in cases where the initial findings are inconclusive or when a rare condition is suspected.
When to Use This Code
- When a biopsy specimen requires a second opinion from a specialist.
- In cases where the initial diagnosis is inconclusive or disputed.
- When a rare or complex oral pathology is suspected.
- At the request of a patient seeking further confirmation of a diagnosis.
- When the original laboratory lacks the specialized expertise required for a specific case.
Documentation Requirements
- Detailed written report of the findings from the consulted specialist.
- Copy of the original laboratory's slide preparation and initial findings.
- Patient's medical and dental history relevant to the biopsy.
- Referral documentation from the requesting dentist or specialist.
- Consent form from the patient for the consultation service.
Billing Considerations
When billing for D0484, it's important to note that this code is typically used for one-time consultations and may not be covered by all insurance plans. Ensure that the patient's insurance covers external consultations. Common modifiers might include those indicating a second opinion or consultation. Frequency limitations may apply, so verify with the patient's insurance provider.
Related CDT Codes
Frequently Asked Questions
Coverage for D0484 varies by insurance plan. It's advisable to check with the patient's insurance provider to confirm if consultations on slides prepared elsewhere are covered.
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