Leonard is a 41-year-old male with limited finances who is concerned about the appearance of his teeth.

DENTAL ASSOCIATES OF ARRINGTON 9550 ENAMEL BLVD. . MOLAR, FL 32811 . 407-555-4703 PATIENT: WOZNIAK, LEONARD ACCOUNT/EHR #: WOZNLE001 DATE: 10/15/18 Leonard is a 41-year-old male with limited finances who is concerned about the appearance of his teeth. He is seeking the best treatment plan for the least amount of money. MEDICAL HISTORY: The patient is alert, normally developed, and is in no distress. Patient takes no medications and denies all organ system disease and allergies. DENTAL HISTORY: He has received intermittent treatment, and the following teeth were extracted due to carles: #14, 15, 19, 20, 21, 30, 31. CLINICAL FINDINGS: Generalized plaque and calculus with staining are evident. There are focal white rough lesions on the mandibular left and right alveolar ridges. These white lesions are asymptomatic and do not rub off. TREATMENT: A complete series, including bitewings, are taken. Prophylaxis is completed. PLAN: Patient to return in 1 week to discuss treatment options for cosmetic measures. Terri F. Davis, DMD TFD/mke D: 10/15/18 10:35:24 T: 10/16/18 04:21:56 Be sure to list the codes, one code per box, In the correct sequence, from top to bottom, and in the proper row. Capitalization, punctuation, and spacing can Impact whether or not your answer is correct. Follow coding best practices. Please list modifiers with the code they relate to as necessary. Include a hyphen in between the code and the modifier. Example Procedure: 43846-74 or for Anesthesia: 00797-P2 You may not need all of the spaces provided. Procedure Anesthesia HCPCS Level II Diagnosis code(s) and any |code(s) and any |code(s) and any code(s) applicable applicable applicable modifier(s) modifier(s) modifier(s)