Teledentistry: Facts, Billing and FYI's

Updated: Apr 1, 2020

The hot topic after recent dental office closures due to COVID-19/Coronavirus is Teledentistry. If you have not been talking about it, do the right thing and start talking about it. If you are an office manager or front office team member, you can get yourself back in the office just by bringing it up. This week, I have been a broken record "Close your dental office, but not your dental business." Let's cover Teledentistry. (SOO many awesome links at the bottom)

What is it?

Telehealth refers to a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telehealth is not a specific service, but a collection of means to enhance care and education delivery. Teledentistry refers to the use of telehealth systems and methodologies in dentistry. Both consultations and continued follow up with a patient are considered methods of Teledentsitry.

Why use Teledentistry?

Recent studies on the use of telehealth services have shown that 70 percent of patients are comfortable communicating with their healthcare providers via text, email or video in lieu of seeing them in person, and 76 percent of patients prioritize access to care over the needs for face-to-face interactions with their healthcare providers. In fact, 30 percent of patients already use computers or mobile devices to check for medical or diagnostic information.

Methods of Teledentistry

PROHIBITED public-facing technologies (examples): Facebook Live, Twitch, and TikTok. ALLOWED: (examples): Apple FaceTime or Skype, Facebook Messenger video chat, Google Hangouts video

Be sure to get a script prepared in advance for your calls. A simple checklist of what to cover on every call will save you time and ensure a thorough c

Is texting or emailing a patient a form of Teledentistry?

Regarding emails and text messages, there has been no mention or addressing email and text communication. HIPAA does not prohibit using email or text communications, but a dental office that wishes to communicate with patients this way must conduct a written risk analysis and implement reasonable and appropriate safeguards.

Which Dental Insurance's are Covering Teledentistry?

As of 04/01/2020 the following dental insurance companies are covering Teledentistry procedures. (We will update this page daily with any new information we receive)

Unum/Colonial Life

Liberty
Metlife
UCCI
Aetna
Principle
Human
Guardian
Ameritas
Delta Dental
Envolve: D9995 will be reimbursed at $12.27 and D9996 will be reimbursed at $14.80.
Sunlife
Unum/Colonial Life
Blue Cross Blue Shield Massachusetts
Argus
Anthem
Dominion National

Coding/Billing

If you physically see a patient in your dental office during the current COVID-19 quarantine environment the services you render in the office should be coded and billed per your current office routines.

When you are providing services in a teledentistry environment one or the other of the following codes would be reported in addition to those cited below:

D9995 teledentistry – synchronous; real-time encounter Reported in addition to other procedures (e.g., diagnostic) delivered to the patient on the date of service.

D9996 teledentistry – asynchronous; information stored and forwarded to dentist for subsequent review Reported in addition to other procedures (e.g., diagnostic) delivered to the patient on the date of service.

D0140 limited oral evaluation – problem focused

D0170 re-evaluation – limited, problem focused (established patient; not post-operative visit)

D0171 re-evaluation – post-operative office visit

D9992 dental case management – care coordination

Documentation for Claims

Screen shot or phots of the conversation
Proper clinical documentation of the exam
Always remember any Teledentistry code submitted must be reported in addition to another procedure (diagnostic code). These are not stand alone codes.

Why?

Serving patients who are unable to get to a dental office with dental hygiene powered by teledentistry can go a long way toward satisfying progressive state dental hygiene regulations. Also, dental needs get documented and reported.

Teledentistry creates collaborations between dental hygienists, dentists, patients and caregivers. The silver lining is when necessary dental work can be coordinated with a local dentist for those patients who can accept treatment.