Compliance and Procedure Code Sets
Do you know who may be held accountable for non-compliance or fraud? If you think it is only the treating doctor, you are incorrect and this self-instructed two-part course is designed for you.
Keeping your practice in compliance starts with understanding what healthcare fraud is and learning how to identify common fraud and abuse patterns. You will understand medical vs. dental necessity and why the documentation must support the code set used. Gain insights on proper coding compliance including knowing when it is appropriate to use the various code sets for medical or dental claims such as: CDT, ICD-10-CM, CPT, ICD-10-PCS, or HCPCS.
Learn how to properly bill for treatment that may not have a code or match a code descriptor. Learn about what is needed when billing code Dx999 unspecified by report procedure.
After the course attendees will:
- Identify and avoid fraud and abuse patterns in their practice
- Understand that healthcare fraud statutes vary by state and discover the proper resources you may use to follow your state’s statutes
- Determine when the documentation supports medical vs. dental billing and when it is best to use the CDT, CPT or HCPCS code sets
- Recognize the importance of the CDT codes and the importance of understanding the annual changes
- Feel confident in understanding the basics of billing code sets and how to use them based on the treatment provided.
Earn One (1) CE credit
Dilaine Gloege is a dental practice consultant with a focus on practice administration to improve insurance claims collection. She helps dental billing professionals collect more from dental billing processes through training in dental and medical procedure coding, coordination of benefits, and documentation. She has written and contributed to many professional publications, numerous blog articles and is the author of Dental ClaimSupport’s Profitable Guide to Coordination of Benefits for Dentists.
Dental Claims Academy
This course is part of a training center for an in-house dental insurance claim group of experts. Get access to all resources--coding knowledge, billing process training, a mastermind group, a discussion forum, and more–as a member of Dental Claims Academy.