What is the Importance of a Dental Billing Code?

What is the Importance of a Dental Billing Code?

Almost 25 years ago, the world of everything dental experienced a change that would forever mark a new age of dentistry. It wasn’t some new technique on how to remove caries from a tooth, or even a new tool to make dentistry easier. It was a dental coding system, referred to as CDT-5 codes, or current dental terminology, 5th edition. So why the sudden change? With dentistry growing and with a need for more uniformity, the Dental Benefit Programs and ADA came together and made the decision to create a coding system that would be implemented throughout all dentist offices.

 

What is the major benefit of a coding system you ask? Imagine life 50 years ago; you arrive at the dentist office and have an amalgam filling done on 3 surfaces, with a pulp cap directly placed. A few years later, you move across country and can’t seem to explain to your new dentist what procedure was done because the treatment terminology they use is different. The struggle of communication became apparent and it was time to implement new standards. Not only was it difficult from dental office to dental office, but from the dental office to insurance companies as well. You can imagine the difficulty in describing in detail the treatment on each patient and justification on why it was necessary. It was equally difficult for the insurance company processing the claim. The time and effort spent by all parties was very inefficient. A standard based coding system could be set in place where you simply say denote the treatment by a consistent code (e.g. 6613 Onlay – cast predominantly base metal, three or more surfaces) and every insurance company would understand the treatment and would be able to quickly determine coverage and issue payment.

 

In this day, we are all about efficiency. Without the dental coding system, the dental office would have to dedicate more staff time to billing and insurance collections and less time on the patient experience. We have come a long way in the dental industry and it and will continue to change in the future. What do you think could be next game changer?

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