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Medical Billing for Dental 5 Part Series: Part 4

Aaaand we're back! Welcome to part four of Dentistry Support's free training series on medical billing for dental procedures. We have covered a lot. Let's get into coding and where the resources exist for the dental community to understand coding.


Medical insurance and dental insurance are two different beasts, and it can be frustrating for dental offices when medical insurance companies won't provide assistance with medical billing for dental procedures. Unlike medical insurance, which is designed to cover illnesses and injuries, dental insurance typically covers preventative care and minor procedures. Medical billing for dental services can be complicated, as dental procedures often have medical implications that need to be taken into account. Unfortunately, many medical insurance companies are not equipped to provide guidance on how to properly bill for these services. As a result, dental offices must navigate the complex world of medical billing on their own, which can be time-consuming and lead to errors that may delay or deny payment.


It's also worth noting that medical insurance companies are in the business of saving money, not paying it out. As a result, they may not have a vested interest in assisting dental offices with medical billing for dental procedures, which could potentially result in higher payouts. Insurance companies often have strict guidelines and codes that must be followed for proper billing, and any mistakes made by dental offices can result in denied claims or delayed payments. It's important for dental offices to take the time to understand these guidelines and codes to ensure that claims are properly submitted and paid in a timely manner. By doing so, they can minimize the risk of financial loss and maximize their chances of getting paid for their services.


There is no quick answer guide. Anyone offering this is likely scamming you or is undereducated in the medical billing for the dental world. We are going to provide you with excellent resources where you can find information on coding that can help you. When you are ready to begin medical billing we have a customized portal that guides you through the answers to the commonly billed medical for dental procedures.



The biggest misconception about ICD-10

The most common question asked about the system is:

"What is the ICD-10 code for this procedure code?" Please note that ICD-10 coding does not work like this. There is no standard or fixed ICD-10 code related to any procedure code


The basic principle of ICD-10 coding


ICD-10 coding is a diagnostic system and dental procedures can be performed as a result of various different diagnoses. The dentist must make and document a diagnosis before a treatment plan can be formulated. The diagnosis is then translated into an ICD-10 code

"What diagnosis led to the treatment being performed?" By answering this question, most of your ICD-10 coding confusion will disappear.

General examinations are, of course, excluded because the diagnosis is not known before the examination. In such instances, special codes exist that can be used for this purpose.



Importance of accurate ICD-10 reporting

ICD-10 coding is an integral part of your clinical records and is required in terms of an international agreement to determine disease patterns and to accumulate diagnostic data. We are aware of the fact that this information has not yet properly been analyzed but, despite our efforts to object to the system, the lack of analysis does not exempt us from the obligation to submit the data. Given that schemes have the right to reject claims on the basis of inaccurate ICD-10 coding, we would like to empower our members with the requisite information to enable them to claim effectively, regardless of our personal opinions regarding the efficacy of the system.



Understanding the proper coding process for medical billing is essential for any dental office, as it can significantly impact reimbursement rates and cash flow. To help our readers navigate this process, we've provided a list of dos and don'ts when it comes to medical billing for dental procedures. Additionally, we've included the above links to helpful resources on ICD-10 and CPT codes. While we advise our readers to use these links as a reference, we also recommend using them in combination with other sources and seeking the guidance of a professional medical biller to ensure that codes are used accurately and appropriately. Our company is committed to guiding our readers through this process, and we encourage them to reach out to us with any questions or concerns they may have.


Thanks for joining us for part four of our medical billing training series. Stay tuned for part five where we'll cover the final tips on medical tips that you won't want to miss. Remember, while understanding medical billing is the foundation to success, it does not guarantee payment or success of your practice. But you can lean on Dentistry Support® for support in understanding medical billing terminology and software.


 

Dentistry Support ® provides remote support for dental offices nationwide. We serve the needs of any size dental office including those with Spanish-speaking needs on both the east and west coasts of the United States of America. Learn more.



Disclaimer:


To learn more about Sarah Beth Herman, the author of all free training content you can read her bio here. These materials are intended to provide helpful information to dentists and dental team members. They are in no way a substitute for actual professional advice based on your unique facts and circumstances. This content is not intended or offered, nor should it be taken, as legal or other professional advice. You should always consult with your own professional advisors (e.g. attorney, accountant, or insurance carrier). To the extent, Dentistry Support ®has included links to any third-party website (s), Dentistry Support ® intends no endorsement of their content and implies no affiliation with the organizations that provide their content. Further, Dentistry Support ® makes no representations or warranties about the information provided on those sites. You can view our privacy policy and terms and conditions by clicking those pages in the footer of our website.

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38 Comments


Syed Ali Hasnain
Syed Ali Hasnain
Jul 27, 2023

Medical coding is crucial in the healthcare industry, encouraging accurate documentation and billing processes. Among the coding systems used in healthcare, the ICD-10 coding system holds significant importance. Healthcare professionals, coders and billing specialists need to understand the impact of ICD-10 coding on medical billing. This is to ensure accurate reimbursement and data analysis.

This blog post provides an overview of ICD-10 coding, its benefits, challenges of implementation, and strategies for successful coding and billing.


https://www.pyramidsglobal.com/icd-10-coding-understanding-its-impact-on-medical-billing/

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Tey Armada
Tey Armada
May 03, 2023

Thank you for part 4!

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lerma navarrete
lerma navarrete
Apr 10, 2023

Thank you for this!

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aryastark1297
aryastark1297
Apr 05, 2023

love how detailed the whole series of articles are!

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Can't wait for part 5!

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