Dental Articles and Resources

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Dental Medical Billing University

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

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

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

Medical to Dental Billing Truth or Dare? 

The Diabetic Patient and Medical Manifestations

Medicaid Compliance and your Dental Practice

 

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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.

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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

PDGs

Provider Documentation Guides

Tooth Numbering & The Oral Cavity

Tooth Numbering & the Oral Cavity

ADA Links and Resources

ADA

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)

ADA Dental Claim Form Instructions

ADA Dental Claim Form Completion Instructions

Evidence-Based Dentistry

ADA Center for Evidence-Based Dentistry

Diabetes Oral Health Topics

Oral Health Topics - Diabetes

Electronic Pediatric Measures

Electronic Pediatric Measures

Dental Quality Alliance

User Guide for Pediatric Measures 2020

Dental Quality Alliance

Dental Quality Measures

Additional Links and Resources

Links 2 Success

Dental Management and Consulting Service

Noridian: Dental Resources

Noridian JE Part B Dental Resources

ADA Dental Claim Form Completion Instructions

ADA Dental Claim Form Completion Instructions

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

Reimbursement Guide for Oral Appliance Therapy for Obstructive Sleep Apnea

Management of sleep related breathing disorders

ACE - Pace CEU's

Webinars and Instant Exam Access

UnitedHealthcare Dental

Clinical Policies and Coverage Guidelines

National Standardized Dental Claim UHC

Utilization Review Criteria

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

Locating Periodontal Disease in ICD-10-CM

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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 ...

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CDT and CPT - The Same but Different!

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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 ...

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Staging and Grading Periodontitis

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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 ...

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

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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 ...

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Important Podcast on Dental to Medical Billing

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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 ...

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New and Exciting Changes in the Dental Industry

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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 ...

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

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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...

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Are NCCI Edits and Modifiers Just for Medicare?

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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 ...

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Should I Bill Dental or Medical?

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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 ...

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Changes in Medicare Advantage and Part D

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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 ...

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

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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 ...

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Documentation Skills that Increase Your Coding

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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 ...

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

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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 ...

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Non-Surgical Periodontal Treatment

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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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Regence: Dental Procedures Under The BlueCard Program?

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This information can be found on Regence/Blue Cross Dental procedures explaining additional benefits for dental procedures. Regence currently does not offer dental benefits, however, there are times a patient can receive treatment with a Blue Cross provider and qualify under their medical benefits. In addition, Regence informs the providers to file these claims ...

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Medical ID Theft

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Medical ID Theft "So, do you guys think you can do something with that?" John asked angrily at our first meeting with him in August 2017 as he slammed a stack of medical bills, EOBs and collection letters - three inches high - down in front of my partner and I. ...

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The OIG Work Plan: What Is It and Why Should I Care?

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The Department of Health and Human Services (HHS) founded its Office of Inspector General (OIG) in 1976 and tasked it with the responsibility to combat waste, fraud, and abuse within Medicare, Medicaid, and the other HHS programs. With approximately 1,600 employees, HHS OIG is the largest inspector general's office within ...

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5 Ways to Minimize HIPAA Liabilities

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Last year was historic for HIPAA enforcement. The HHS Office of Civil Rights collected a record $23.5 million in settlements and judgments against providers guilty of HIPAA violations. To avoid becoming part of that unwanted statistic, it’s important to pay extra close attention to five key areas of HIPAA vulnerability. Take ...

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Are You Protecting Your Dental Practice From Fraud?

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With the expansion of dental coverage through Medicaid and Medicare Advantage plans, an ever-increasing number of dental claims have come under scrutiny for fraud. One such payer, Aetna, is actively pursuing dental fraud by employing their special investigative units (SIUs) to identify and investigate providers who demonstrate unusual coding and ...

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Select the webinar title to view a summary and link to the webinar video.

Diseases of Oral Cavity and Salivary Glands

Diseases of Oral Cavity and Salivary Glands

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"The Dental Office" CDT Codes, Crosswalking to CPT, and Dental Auditing

Join Aimee Wilcox in an informative webinar on procedural coding for the dental office, how CDT codes crosswalk to CPT codes for medical billing, and auditing concerns to watch for.

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Anatomy of the Mouth and Diagnosis in the Dental Office

Anatomy of the Mouth and Diagnosis in the Dental Office

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How to PREVENT and HEAL Dental Problems so You Can Enjoy a Healthy Body and Life

In this webinar Dr. Jorgensen will share with you the REAL causes of dental disease and techniques for prevention and healing. You will also learn about dental problems that may be making you or your patients SICK, how to identify them, and what can be done to help them get better. Finally, she will tell you about cutting edge dental and health practices you need to know about to improve your patient's health, and how to find a dentist that can provide this care. Don't miss this life-changing webinar!

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Proper Coding and Billing for Drugs, Biologicals and Injections

Proper Coding and Billing for Drugs, Biologicals and Injections

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How to Check NCCI Edits Using FindACode

How to Check NCCI Edits Using FindACode

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Select the podcast title to view a summary and link to the podcast.

Do You Have All the Right Dental Resources Needed to Succeed in Dental Medical Billing and Coding?

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.

Listen to the podcast →




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