Common Dental-Medical Coding Systems can Improve Care and Reimbursement in Dental Practices

New requirements and standards have changed the medical billing and coding landscape considerably. This applies to the dental scenario too. With new dental claims submission and diagnostic codes requirements, the dental billing and coding landscape has also undergone significant changes. In some states, Medicaid Programs require diagnostic codes in dental claims submission. When required, an appropriate ICD-10 diagnostic code along with the valid and current code on Dental Procedures and Nomenclature (CDT) code for the service performed has to be reported. The code should be relevant and specific enough to support the service reported. In other words, ICD-10 could be a requirement for procedures performed in dental practices if the procedures are billed on a medical claim form or submitted to specific insurance payers. The current system is one in which:

• Private and public insurance programs treat electronic health records (EHRs) for dental and medical care as completely separate
• Integrated hospital systems and community health centers offering medical as well as dental services rarely have integrated health records systems

Industry experts point out that common medical and dental coding systems, interoperability, and use of quality software can maximize care benefits and reimbursement in dental practices. Let’s see why dental-medical health information technology (HIT) through a common EHR system or interoperability is crucial.

Rationale for a Shared EHR System for Medical and Dental Providers

Oral health and general health are inextricably linked. Proper dental care keeps bacteria in check and safeguard overall health. Studies suggest that oral health might affect, be affected by, or contribute to various diseases and conditions such as endocarditis, cardiovascular disease, pregnancy and birth, diabetes, HIV/AIDS, osteoporosis, Alzheimer's disease, etc.

This correlation between dental and general medical issues is the rationale behind the argument for a common EHR system for medical and dental practices. For instance, a person with a complex cardiac condition who needs dental treatment would receive proper care only if there was barrier-free communication between the dental provider and the cardiologist. Dental and primary care coordination is also crucial in pediatrics, with increasing stress on early dental visits and the institutionalization of oral healthcare.

Integrated HIT or a shared EHR would make this possible. Proper provider would not ensure timely and effective treatment but also accurate reporting of the services provided. This will streamline dental and medical billing and coding and improve reimbursement for both sets of health care providers.

Accurate Coding and Efficient Electronic Claims Processing Services

A variety of technologies are available to help dental providers improve their operational efficiency. The key to increasing revenue is choosing the right practice management system, electronic dental records, supporting medical software system and dental-medical HIT integration.

When it comes to efficient and timely dental coding and billing, partnering with the right outsourcing company is crucial. In a professional medical coding company, the team of certified coders would be well aware of the latest developments including the new codes reflecting technological advances in dentistry, ICD-10 that allows for more specific dental coding, new and revised diagnostic codes for radiography, and revised anesthesia codes, ensuring accurate claim submission. Such companies work with the latest software to manage the entire billing and claims processing and submission process. With advanced resources, they help their clients reap the benefits of the latest technology and improve their profitability.

OSI provides RCM services for dental and medical practices of all sizes and specialties. Services include billing, insurance verifications, prior authorizations, coding, A/R management and more.