Of all the administrative tasks in an office, many are important, but few are as important as ensuring accurate coding. And, as anyone who has worked in billing and coding will tell you, it’s not easy or fast. Understanding some of the foundational principles is the first step to mastering this essential process.
Let’s look a bit more closely at the types of codes you or your staff may encounter:
ICD-10 codes are diagnostic codes used to group and identify diseases, disorders and symptoms and inform the payer why the procedure was performed. ICD stands for International Classification of Diseases and 10 refers to the version, which is updated at least once a year.
CPT stands for Current Procedure Terminology. This code set is used to report medical procedures and services to payers and is kept up-to-date by the American Medical Association. If dentists perform medical procedures, they must report them with CPT codes and file them with medical insurance providers for payment.
CDT or Current Dental Terminology codes will be far more familiar.. CDT is the HIPAA standard code set for dental diagnoses and procedures. There are 12 categories ranging from diagnostic to orthodontics, covering everything from preventative to restorative care and treatments.
If you are filing a claim on the patient's medical insurance, every medical claim requires at least one ICD-10 code to be reported. If you don’t include one, your claim will be rejected.
What You Need to Know About Dental Coding
- Understand the difference between CDT, CPT, and ICD-10. When it comes to coding, coding correctly is paramount. That means knowing when a procedure falls into the cross-coding space and requires the use of ICD-10 or CPT medical code. This difference is an important factor in how procedures are covered by insurance and some insurers might have very specific coding requirements.
- Coding is a learning process. Having a dedicated person for dental coding and billing is essential. By learning the process and the codes, the better they get at it.
- Staying up-to-date is key. Regardless of the coding system, codes are updated twice a year (remember that ICD-10 indicates the most current version # of those codes). That means changes are frequent and staying on top of what’s changing and how that may impact your billing will help you avoid potentially costly errors.
- Consider a yearly review. If you're tracking practice analytics, you should be able to see where coding errors are costing you and, from there, you can adjust.
- Understand the complete claims process. This can help you identify areas that are tying up your resources and, ultimately, impacting your revenue cycle.
- Ask for help when you need it. Rather than continuing to delay payments and jeopardize revenue and patient care, getting help with accurate dental and medical cross-coding is a much better option.
For many practices, the first solution to coding problems is to look to outsource. But, what if you brought dental coding expertise in, without adding new staff? Consider experience who’s already bringing you improved workflows and efficiencies for your practice, consider getting coding support.
VDA Member Perks recommends and endorses iCoreCodeGenius to help you quickly and efficiently, complete the ICD-10 and CPT coding you need to submit accurate claims and keep your revenue flowing, without adding to your headcount. If you’re ready to see how it helps you code in less than 60 seconds, book a demo today!