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
- 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.