Adopting dental cross medical coding for maximum reimbursement of bills

December 11, 2013

Dental codes are distinctly different from other medical codes and dentists are more than comfortable filing their reimbursement claims with carriers in the traditional way by utilizing those codes alone. However, there are certain dental procedures which can be cross coded at the time of filing medical claims and can derive your dental practice much higher financial returns. Dentists shy away from adopting cross medical coding for the fear of delayed reimbursements, audits and claim denials. It is essential to dispel this fear because not only your dental practice but your patients have a lot to gain from cross medical coding in today’s healthcare scenario.

Many dental procedures have been recognized for their medical nature with extensive research in the systemic link. Despite this development, dental practitioners are hesitant in adopting cross medical coding because they don’t understand the requisites and correct method of cross coding. Especially the difference between CMS-1500 medical reimbursement forms from regular dental CPT coding discourages cross coding practices in dental care providers. It is therefore, essential to understand the value-add of dental cross medical coding for the financial health of your practice –

  • Better reimbursement rate – Medical insurance carriers offer better reimbursement rates than dental carriers. While that is the most practical reason to adopt dental cross coding despite the ingrained difficulties, it’s not the only one.
  • Sturdier payer mix – Most patients access dental insurance via their employers, but in a sluggish economy like ours, many employers are revoking dental insurance for their employees as a cost cutting measure. However, medical insurance still continues to be offered by most employers and government is increasing covering more and more individuals under Medicare and Medicaid. Therefore, if you adopt dental cross coding compliant with healthcare reforms, you not only benefit the financial condition of your clinic but benefit your patients as well.
  • Higher claim settlement ratio by medical carriers - Medical insurance carriers have a better reimbursement turnaround time than dental carriers. Therefore, for dental procedures correctly coded for medical reimbursement, claim settlement ratio and time improves dramatically.

Dental cross medical coding can be done for various procedures regularly offered as dental care by dentists, such as –

  • Trauma and oral surgical procedures
  • Sleep apnea and TMD procedures
  • Endodontic procedures
  • Prosthodontic procedures that are medically necessary
  • Implant and periodontal procedures
  • Oral cancer screening
  • Patients requiring dental care due to other medical illnesses like Parkinson’s, heart disease, hormonal conditions, etc.
  • Radiograms and other medically necessary diagnostic procedures

Medicalbillersandcoders.com is a medical billing and coding service provider that offers the immense experience and skill of dental medicine experts for your specific needs. Cross medical coding is complicated for those who want to try it for the first time and while your in-house medical staff may not be able to cope with the challenge, a specialist like medicalbillerandcoders.com can really make a difference in your billing practices.


Category : Dental Billing