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Is this dentist skirting the law with his coding practices?

from Dentistry IQ

Dentistry IQ answers: "I work the front desk of a small dental practice where the doctor himself handles the coding and I collect payment after patient visits. Lately, I’ve started to question the doctor’s ethics and the legality of some of his practices. He will bill for an office visit (9430, which is typically not covered by insurance) and a problem-focused exam (0140) in the same visit. My understanding is that this is not allowed. Moving forward, he does not want to bill 9430 to insurance at all as it is usually not a covered service and therefore, he can charge his office fees. (These are his words.) Also, since most insurances cover cleanings only twice a year, can he charge patient office fees and not bill to insurance for additional cleanings? I’d like some clear answers before I begin to lose all trust in my employer." more

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7701 Las Colinas Blvd., Ste. 800, Irving, TX 75063