by Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Mar 13th, 2023
In June of 2022 the ADA addressed the Center for Medicare and Medicaid Services regarding concerns the Dental community has when it comes to limited access for pediatric and adult patients and access to dental rehabilitation surgery in the outpatient surgery and ASC settings. The issue is there are procedures a patient may need that are ancillary to a covered procedure and should've been done in a surgical setting. This resulted in a solution to create a new code to help patients get care for complex dental procedures in the outpatient and ASC settings. See the Pub-100-04 Medicare Claims processing manual.
6. Dental Coding Updates
a) New HCPCS Code Describing Facility Services for Dental Rehabilitation Procedure(s).
For CY 2023, we established HCPCS code G0330 to describe facility services for dental rehabilitation procedures performed on a patient who requires monitored anesthesia (for example: general, intravenous sedation (monitored anesthesia care)) and use of an operating room. We established the code to enable HOPDs to bill the technical, facility-fee component of
dental rehabilitation services only. We believe this code will mainly be used to describe the facility fees for services performed on vulnerable populations, including patients with disabilities, who require these procedures to be performed under anesthesia due to special health needs. Table 7 of CR 13031, lists the long descriptor, status indicator, and APC assignment for HCPCS code G0330. For information on the payment amount associated with HCPCS code G0330, refer to the January 2023 OPPS Addendum B.
References/Resources
About Christine Woolstenhulme, QMC QCC CMCS CPC CMRS
Christine Woolstenhulme, CPC, QCC, CMCS, CMRS, is a Certified coder and Medical Biller currently employed with Find-A-Code. Bringing over 30 years of insight, business knowledge, and innovation to the healthcare industry. Establishing a successful Medical Billing Company from 1994 to 2015, during this time, Christine has had the opportunity to learn all aspects of revenue cycle management while working with independent practitioners and in clinic settings. Christine was a VAR for AltaPoint EHR software sales, along with management positions and medical practice consulting. Understanding the complete patient engagement cycle and developing efficient processes to coordinate teams ensuring best practice standards in healthcare. Working with payers on coding and interpreting ACA policies according to state benchmarks and insurance filings and implementing company procedures and policies to coordinate teams and payer benefits.
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