In an upcoming Dental Claims Academy webinar, we will be discussing ICD-10-CM and applying diagnostic codes to dental claims. Claim rejections happen all the time, that’s why it’s important to always be learning about how to avoid this so that your practice can get paid quicker!
Things are ever-changing in the dental industry. Regulations, CDT codes, HIPAA rules… It's so much to keep up with. It’s imperative that your dental practice is up to date on all of these things, though. Education is the key to maintaining compliance whether it is CDT coding, record keeping, or HIPAA. It is crucial that you invest in ongoing education for your team.
Did you know D5875 is a billable service? It is common for a patient with an existing denture or partial denture to have implants placed. The existing denture or partial dentures are modified to fit the implants placed. This may be modification for the denture to be used as an interim during the healing phase following implant placement. The denture may also be modified with the intention of it being the definitive implant/abutment supported denture (e.g., immediate denture modified after implant placement).
Is it a sealant, preventive resin restoration or a filling? What’s the difference?
Making the decision to be in-network with a dental Preferred Provider Organization (PPO) can bring challenges to your dental team. To be an in-network provider, you must credential with the insurance payer. But proper credentialing involves many steps and can consume much of one team member’s time. As an outsourced dental billing company, we have worked with hundreds of clients taking care of the credentialing process on their behalf. During the credentialing process, one problem you may face is how to submit claims properly. The challenge occurs most often when a treating provider joins a practice as an associate practitioner. During the credentialing process, practices are often tempted to submit claims using the already credentialed doctor or owner doctor listed as the treating provider. This is inappropriate because that provider may be receiving reimbursement he is not entitled to receive.
There is often confusion over what defines an adult prophy and a child prophy. The codes include D1110 (adult prophylaxis) and D1120 (child prophylaxis). Most of us know dental plans are age-based from a reimbursement perspective. However, age does not determine how a prophy is reported.