Dental Articles and Resources

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Must Watch VIDEO Using Find-A-Code for Medical Billing 


Dental Medical Billing University

Dental Medical Billing University offers a rigorous academic program with a history of excellence in medical studies. 

10/06/21 Dental-Provider Specialty Taxonomy Codes

10/12/21 Staging and Grading Periodontitis

5/04/20 Locating Periodontal Disease in ICD-10-CM

11/4/2020 Dental Implants: Medical Coding and Reimbursement By Christine Taxin


09/21/2020 Important! Podcast on Dental to Medical Billing

******Summary of 2019 Changes to the ADA Dental Form******



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Code Sets

ICD-10-CM Codes

ICD-10-CM Diagnosis Codes

CPT Codes

CPT® Current Procedural Terminology® Codes

CDT Codes

Current Dental Terminology Codes

ICD-10-CM: K00-K14

Diseases of oral cavity and salivary glands (K00-K14)

ICD-10-CM: M26-M27

Dentofacial anomalies [including malocclusion] and other disorders of jaw (M26-M27)

ICD-10-CM: S00-S09

Injuries to the head (S00-S09)

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Validate using NCCI edits for errors in code selection.

Pro Fee Calculator

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UCR Fees

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CMS 1500 02/12 Claim Form Instructions

Medical Claim Form Instructions

Using Tools in Find-A-Code - Dental to Medical

Video tutorial of our Dental tools


Provider Documentation Guides

Tooth Numbering & The Oral Cavity

Tooth Numbering & the Oral Cavity

InnoviHealth Products and Resources

Dentistry ICD-10-CM Cheat Sheet for 2022

Dentistry ICD-10-CM Cheat Sheet for 2022

Dentistry Reimbursement Guide for 2022

Dentistry Reimbursement Guide for 2022

QPro Medical Certifications

Dental Medical Billing and Coding Certifications and Classes

ADA Links and Resources


American Dental Association

ADA Guide to Dental Procedures

DA Guide to Dental Procedures Reported with Area of the Oral Cavity or Tooth Anatomy (or Both)

Diabetes Oral Health Topics

Oral Health Topics - Diabetes

Evidence-Based Dentistry

ADA Center for Evidence-Based Dentistry

Preventive Dental Services

Preventive Dental Services

ADA Dental Claim Form Instructions

ADA Dental Claim Form Completion Instructions

Additional Links and Resources

Links 2 Success

Dental Management and Consulting Service

Noridian: Dental Resources

Noridian JE Part B Dental Resources

Drugs and Biologicals Pub-100 Ch 17

Drugs and Biologicals Pub-100 Ch 17

Billing Requirements for OPPS

Billing Requirements for OPPS Providers with Multiple Service Locations

Dental Coding, Billing, and PM Topics

Coding, Billing, and Practice Management Topics

ACE - Pace CEU's

Webinars and Instant Exam Access

UnitedHealthcare Dental

Clinical Policies and Coverage Guidelines

CMS Measures Inventory Tool

CMS Measures Inventory Tool

National Standardized Dental Claim UHC

Utilization Review Criteria

Dental and Medical Billing

Dental Medical Billing Membership and Online Classes

Reimbursement Guide for Oral Appliance Therapy for Obstructive Sleep Apnea

Management of sleep related breathing disorders

ADA Quick Guide

ADA Quick Guide to In-Office Monitoring and Documenting Patient Blood Glucose and HbA1C Level

Select the title to see a summary and a link to the full article.

Staging and Grading Periodontitis


We now understand periodontitis may present itself as a manifestation of systemic diseases in fact; according to DeltaDental, research shows that more than 90 percent of all systemic diseases have oral manifestations, including swollen gums, mouth ulcers, dry mouth, and excessive gum problems. Some of these diseases include: Diabetes Leukemia Oral cancer Pancreatic cancer Heart ...

Summary of 2019 Changes to the ADA Dental Form


In 2019 the ADA revised the ADA Dental claim form to incorporate editorial changes to further its consistency with the 837D. The previous update was in 2012, the changes in 2012 were made to incorporate the capability to report diagnoses codes.   Some of the important changes include Bx# 8 and 15, the description was updated ...

Dental-Provider Specialty Taxonomy Codes


The National Uniform Billing Guidelines require the use of taxonomy codes for claims submissions on the ADA-Dental claim form and the CMS-1500 Medical Claim form. When reporting the taxonomy code, be sure the provider is contracted with the payer under the taxonomy code being reported. We have listed the general ...

Billing Dental Implants under Medical Coverage


Implants can be costly to the patient and the provider, and it is crucial to understand how to bill a patient’s medical insurance to ensure there is adequate coverage for the best treatment. Implants are commonly billed in a dental office under a patient’s medical benefits.    Implants could be considered ...

Compliance in the Dental Office or Small Practice


If your practice does not already have a compliance program in place, you will want to get started after reading this article. We have uncovered some important findings with the Office of Inspector General (OIG) in dental practices you need to be aware of. A compliance program offers standard procedures to follow, ...

Locating Periodontal Disease in ICD-10-CM


When coding a diagnosis for periodontal disease, keep in mind there are more options than just chronic or acute. To get started, look at chapter 11, Diseases of the digestive system (K00-K95). Looking at this section a little further, you can see this is where the oral cavity is coded ...

CDT and CPT - The Same but Different!


Reporting a CPT code for an evaluation of a patient is based on time and if the patient is a new or established patient. Evaluation and Management codes are different than other codes, it is important to understand how they are used, prior to 2021 they were based on a ...

Locating a Diagnosis Code in ICD-10-CM for Dental Offices


Diagnosis codes used to report with procedures are called ICD-10-CM - International Statistical Classification of Diseases. These codes are published annually in October. To find a diagnosis code in ICD-10-CM, it is important to understand how the chapters and sections are set up. Each chapter is broken down into sections and ...

Important Podcast on Dental to Medical Billing


Be sure and check out this discussion with LaMont Leavitt (CEO of innoviHealth) and Christine Taxin (Adjunct professor at New York University, President of Dental Medical Billing, and Links2Success).  Some of the resources and tools they discuss will help you with your dental coding/billing and education. Do You Have All the Right ...

New and Exciting Changes in the Dental Industry


My colleagues and I are nerds for information on all things billable—or not billable—in the worlds of dental and medical insurance. One of the most puzzling challenges for me over the past 15 years of teaching has been to understand why we on the dental side are segregated out of ...

Modifier 50 — Four "Must Know" Tips For Getting Paid


Modifiers added to an HCPCS or CPT© code alters the code description, providing clarity about the service for proper claim processing and reimbursement. Here are four things you must know about modifier 50 to ensure proper payment. - Modifiers are either informational or payment related. Informational modifiers provide additional...

Are NCCI Edits and Modifiers Just for Medicare?


The National Correct Coding Initiative (NCCI) edits were developed by CMS to help promote proper coding and control improper coding that leads to incorrect payments with part B claims. It is important to understand that NCCI edits do not include every possible code combination or every type of un-bundling combination. With that ...

Should I Bill Dental or Medical?


While you likely find yourself focusing on fewer patients and more on emergency care, it’s a good time to understand how medical billing can allow patients with active infection in the oral cavity to seek the treatment they need.  Forms need to be filled out correctly, and you must carefully follow ...

Changes in Medicare Advantage and Part D


The Centers for Medicare & Medicaid Services finalized several changes in Medicare Advantage and Part D on Friday.  The Trump administration has finalized several changes in Medicare Advantage (MA) and Part D in anticipation of bid submissions on June 1. The Centers for Medicare & Medicaid Services (CMS) released  Friday that includes ...

ADA is Asking for HELP with Third-Party Payers for Dentists


With these unprecedented and extraordinary circumstances, dentists are facing new challenges with reimbursement with what is allowed and covered under their contractual obligations with their payers. The ADA recognizes the struggles dental providers are facing and is urging third-party payers to adopt new reimbursement procedures and adjust their fee schedules to help ...

Documentation Skills that Increase Your Coding


Evidence-based medicine such as the updated periodontal staging and caries lesions also gives well-defined information about the clinical condition itself. You cannot just look at the codes, you need to check the policy. When I am coding or teaching coding, you need to use clinical indications when working with documentation ...

Documenting telephone calls at your dental practice is just as important as documenting patient visits.


Documenting telephone calls at your dental practice is just as important as documenting patient visits. Similar to other documentation, the common rule when it comes to call documentation is that if it is not documented, it did not happen. Therefore, every clinically relevant telephone call should be documented. Clinically relevant calls ...

Non-Surgical Periodontal Treatment


AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.SCALING AND ROOT PLANINGScaling ...

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New Dental Codes for 2021 and Find-A-Code Dental Tools/Resources

Outline of Presentation: - Why Dental coding is changing - New 2021 Dental Codes - Why Cross Coding is Not a Choice - New Dental Tools & Resources in Find-A-Code Be ready for 2021 with complete understanding of the new dental codes. Understand what codes are not covered under dental, and how to bill with medical codes.

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