Medical billing for bone grafts, oral implants, and CBCT

Rose Nierman helps to decode some coding issues on your medical-billing journey.

Rose Nierman offers tips on beginning your medical-billing journey with the right tools

Great news! Becoming a cross-coding office increases access to care. With assistance from medical insurance, many patients can move forward with needed treatment. Medical plans do not have the $1,000 yearly limits and frequency rules for exams and imaging that you see with dental plans. The icing on the cake is that when medical insurance reimburses for oral surgeries, you save dental insurance benefits for routine dental procedures.

Begin your medical-billing journey with the right tools, starting with International Classification of Diseases (ICD-10) codes. A checklist of ICD-10 codes helps document conditions, symptoms, and diseases. During your exam, document conditions such as bone atrophy, jaw pain, osteitis, or difficulty masticating, and then assign an appropriate ICD code.

Procedure codes in medical billing are referred to as Current Procedural Terminology (CPT) for exams, radiograhs, surgeries, and appliances. Just like dental has its own claim form, so does medical (CMS-1500 claim form). Claims can also be submitted electronically. For the best results, be sure to send a narrative report of medical necessity with the claim or preauthorization.

Medical insurance may consider the following services as medically necessary:

  • CBCT, panorex, or tomography
  • Screening exams
  • Bone grafts and implants
  • Third molars and surgical extractions
  • Oral infection or cysts
  • Sleep apnea appliances
  • TMJ appliances
  • Accidents to teeth
  • Mucositis and stomatitis
  • Frenectomy
  • Biopsies
  • Botox injections

Getting started with medical billing

Cross-coding courses and manuals are available to learn the process of medical billing. Nierman CE+, an online medical billing course for dental practices, was recently launched for offices interested in remote training. In today’s economy, it’s essential for dental offices to maximize insurance. Medical billing may help patients get needed treatment and help your practice with case acceptance. Every dental practice can do it!

About Nierman Practice Management

Rose Nierman’s online medical billing course series, Nierman CE+ and her live cross-coding continuing education courses have helped thousands of dental practices learn and apply medical billing. Her company, Nierman Practice Management, created DentalWriter™ software to generate medical claims and narrative reports, and Nierman Medical Billing Service to handle the insurance communication for clients. Ms. Nierman and her company have been dedicated to helping dentists and their teams for 32 years.

On your medical-billing journey, the road may lead you to working with patients on airway health. See Rose Nieman’s article on cross coding and airway health, at https://dentalsleeppractice.com/practice-management/join-the-movement-for-crosscoding-and-airway-health/.

Rose Nierman is a pioneer and leading expert in cross-coding and medical billing in dentistry. She made it her mission to help dentists get paid by medical insurance and, in 1988, founded Nierman Practice Management. Ms. Nierman has educated thousands of practices to become successful cross-coders, created the leading software system DentalWriter™ that transforms specific questionnaire and exam data into narrative reports and medical claims, and launched Nierman Medical Billing Service to streamline the reimbursement process for dental practices. Contact Nierman Practice Management at contactus@dentalwriter.com or 1-800-879-6468.

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