According to the American Cancer Society’s recent study , oral cancer continues to be on the rise. This being my 35th year in dentistry and many years being a clinical team member, I have seen many instances of oral cancer, more than I like to count. I have also had friends who did not survive oral cancer and those that have, for which I am very thankful. April is Oral Cancer Awareness month. Early detection saves lives! I thought it would be the perfect time to discuss CDT codes related to early detection of oral cancer. This article will address code D0431 and editorial revisions to the descriptors of D0120 and D0150 for CDT 2021.
You see two long words with the same prefix and think “probably is close to the same thing!” In this case, they actually have different meanings. In the dental world, many people use the terms predetermination and preauthorization interchangeably. However, there can be some differences in the meaning depending on its purpose. Confused? We get it. Not everyone’s an expert on insurance terms, and they can get really complicated. Our team of experienced dental billers at Dental ClaimSupport have submitted many predeterminations and preauthorizations over a number of years. We know the pros and cons of this practice and understand the meaning of these terms and the payer’s views. We value education and learning as much as we can about dental billing terms so that we can move through the process seamlessly.
National Provider Identification numbers, better known as NPI numbers, can be confusing to say the least. Many dental offices suffer from not knowing exactly what these numbers truly mean and how they need to be reported on a 2019 ADA claim form. This can result in claim delays and lost revenue. We are here to help. Fortunately, our team at Dental ClaimSupport is well versed in NPI numbers and accurate claim submission. Every doctor has to obtain an NPI number to practice dentistry. However, the billing entity or dental practice where the dentist works can have its own NPI number too. Confusing, right?
You may already be performing COVID-19 tests in your practice or maybe you are thinking about implementing testing. If so, you might be wondering if there are codes to document this procedure. The good news is yes there is! This article will review the current suite of CDT codes available to document COVID-19 tests. The Code Maintenance Committee (CMC) is tasked with ensuring dentists have CDT codes to accurately document what you do. CMC met for a called meeting in the Spring of 2020 at the start of the pandemic for discussion of potential future CDT codes needed to describe antigen and antibody testing in the dental setting.
Maybe you’re a dentist just starting out or joining a dental practice as an associate. Maybe you’re an insurance coordinator in charge of claim submission and collections. Either way, NPI numbers can be a source of confusion in a dental office. What you might not know is NPI numbers can cause claim rejections or payment delays, causing your business to lose money. At Dental ClaimSupport, we work with many kinds of dental offices around the United States, all shapes and sizes. In our experience working with so many dental offices, we’ve seen NPI numbers be the reason for payment delays in the billing process. This can especially happen with start-up offices or offices adding providers. In this article, you will learn what an NPI number is, the various types of NPI numbers, and how NPI numbers can affect your claim payments. By reading this article, you will be better educated on the importance of NPIs and what they mean to the overall success of your practice. What is an NPI number and why must I have one? A National Provider Identifier (NPI) is a unique,10-digit identification number for individual healthcare providers and organizations such as dental practices. NPI numbers are assigned by the Centers for Medicaid and Medicare (CMS) and are used to identify an individual healthcare provider (NPI 1) and billing entities or dental practices (NPI 2)
CDT code D1355 is a new code for CDT 2021, which became effective, January 1, 2021. Let’s take a look at what procedure this new code represents. D1355 caries preventive medicament application – per tooth
CDT code D4355 is appropriate for the patient who presents with heavy supragingival plaque and calculus preventing comprehensive oral evaluation with a diagnosis from being completed. For this type of patient, an accurate periodontal charting and probing cannot be obtained until the debris is removed from the teeth and healing has occurred. A periodontal charting and probing is necessary to make a diagnosis. D4355 is not intended to be a preliminary procedure prior to perio therapy, a common coding error seen. The intent is to perform a full mouth debridement to enable a comprehensive oral evaluation.
Medical and dental coding have many similarities and are not as different as we in the dental profession are led to believe. All healthcare providers render services such as office visits, radiographic imaging services, etc. healthcare providers are also required to document what services are rendered and why a service is needed in a health record. Codes are used to report services rendered to insurance payers for reimbursement determination. We communicate to payers through applying codes to the claim form, whether medical or dental. So yes, it is similar with each code set having a specific purpose. In this article, we will do a deep dive comparing how medical coding and dental coding affect your claim submissions.
The medical claim form, in itself, can be a source of confusion and frustration for many dental team members. Claim form submission errors are the most common cause for claim rejections. They’re also the biggest source of frustration and the reason that many dental team members give up on filing claims to medical insurance. At Dental ClaimSupport, our team of knowledgeable expert medical billing specialists assist our clients with billing dental procedures to the patient’s medical plan successfully on a daily basis. The dental world is changing. Servicing hundreds of providers, we have seen the trends of common dental procedures needing to be billed to medical insurance.
As a dental professional, you're familiar with the periodontal maintenance procedure and CDT code D4910. But applying this code can still be confusing.
