Patients often take for granted the seamless process of visiting a dental clinic, receiving treatment, and then having their insurance handle the payments. Little do they know that behind this seemingly simple process lies a complex system known as dental coding, which plays a vital role in legitimate insurance reimbursement. Dental coding is an essential aspect of the dental billing process, ensuring that services are properly reported, billed, and reimbursed accurately. In this blog post, we will delve into the significance of dental coding and its impact on insurance collections.
Understanding dental coding
Dental coding is the standardized method used by dental professionals to describe the services provided during a patient’s visit. Just like medical coding, dental coding employs a series of alphanumeric codes to identify specific procedures and treatments.
Current Dental Terminology (CDT) provides a consistent method of documenting and reporting dental procedures. The Council on Dental Benefit Programs (CDBP) is responsible for m maintaining the CDT code set. The CDT code set encompasses a vast array of dental procedures, ranging from routine check-ups and cleanings to complex treatments like root canals and dental implants.
The role of dental coding when submitting dental claims
Let’s take a look at the dental practice revenue cycle pipeline. While dental coding plays a crucial role in submitting clean dental claims, it has an expansive role in the dental practice revenue cycle as a whole. Accurate dental coding impacts a dental practice’s revenue cycle from the time a patient is presented with a treatment plan to when the dental claim is submitted to the patient’s insurance.
Let’s zoom in on the dental claim submission for reimbursement. In 2000, the United States government declared the Current Dental Terminology (CDT) code set as the national terminology for reporting dental procedures to insurance and third-party payors. This means that for a dental claim to be processed timely by an insurance payor, the claim must have valid and accurate CDT codes from the most current CDT code set.
Insurance companies, however, are not the only entities that rely heavily on dental coding. When a patient visits a dental clinic for treatment, the dental team documents the services provided and assigns appropriate CDT codes to each procedure. These coded procedures are then used to communicate treatment rendered to the dental team, and other providers, so it is vital that correct CDT codes are reported.
Dental coding & billing knowledge is closer than you think
As you can see, dental coding plays an indispensable role in insurance collections and the overall revenue cycle of a dental practice. This is why you need team members with dental billing & coding knowledge and resources. Depending on your location, these unicorn team members may be hard to find. A growing trend is to outsource dental coding & billing to knowledgeable team members across the country that can keep your revenue cycle intact and on track. CLICK HERE to learn more.
About the Author
Dr. Charles Blair is the dental industry’s leading authority on insurance coding strategies, fee positioning, and strategic planning. Dr. Blair’s extensive background and expertise make him uniquely qualified to share his wealth of knowledge with the dental profession. He is a nationally acclaimed speaker and has presented hundreds of programs across the country at various dental study clubs, meetings, and conventions. Also, a widely-read and highly-respected author and publisher, he currently offers several guides and manuals including Dental Coding with Confidence, Dental Administration with Confidence, Medical Dental Cross Coding with Confidence, as well as Insurance Solutions Newsletter.
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