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Key differences between ICD 9 and ICD 10 for Dentists

April 30, 2014

The differences between ICD 9 and ICD 10 have kept the whole medical fraternity, in the US, worried. But, of all medical areas, dental practices find themselves acutely unprepared for handling ICD 10. This lack of preparation has to do with the fact that ICD 10 coding works on the cause and effect principle, where the cause of a dental condition has to be conveyed via documentation to justify the dental treatment administered to treat the condition. In other words, documentation has to be provided to support each code used to claim a dental service.

What makes this scenario difficult for dentists is that most dental ailments are (tooth ache, extraction) such that they require addressing the symptoms of a condition without always going into what caused it, unlike, say, cardiac conditions. And so the practice of considering a condition and its remedy based on past documentation or documenting native specifics related to a condition - is not very widely followed in dentistry. ICD 9, given its non-documentary nature, never caused any problem to dental practices for lack of documentation.

Some of the condition-related details that documentation under ICD 10 will convey:

  • Specific anatomical descriptions (mainly location of, say, caries and their sphere of effect)
  • Separation of risk and severities (after-effect of a dental treatment and the intensity of a condition)

These details went un-tapped under ICD 9. But under ICD 10 they would have to captured and conveyed.

This specific and precise character of ICD 10 makes it very structurally different from ICD 9. The main structural differences between the two standards are

  • Length of codes - ICD 9 has 3 to 5 characters whereas ICD 10 has 3 to 7
  • Number of codes – ICD 9 has 13000 codes while ICD 10, 68000
  • Flexibility of codes – ICD 9 codes are limited in how widely they can be used but ICD 10 ones provide more flexibility
  • Detail orientation – The amount and granularity of details available in ICD 10 codes are much higher than ICD 9

So the needs for successfully operating under the ICD 10 standards are documentation and structural knowledge of ICD 10 codes which will help use them accurately.

MBC’s Revenue Management Consulting services can assist you to set your documentation in order so that there is a thorough documentation process running together with the dental procedures absorbing and archiving records as they pile up in the course of a treatment procedure and then passed on to billers and coders who accurately use them to support dental claims. To do this, we can help assess your in-house revenue management cycle ensuring that there is sound coordination between various components of your dental practice facilitating smooth flow of data.

We can also train your staff to handle dental records and use them appropriately to meet medical billing and coding needs. Additionally, we will help you to set up proper software platform to transport your documents back and forth while preparing and submitting claims.

We have helped several dental practices to:

  • Develop a comprehensive understanding of the revised code structure
  • Understand how ICD 9 and ICD 10 code sets differ
  • Know the new ICD 10 terms
  • Know ICD-10 codes applicable to different kinds of dental procedures
  • Understand how trauma claims are coded
  • Understand the best ways to implement ICD 10 codes

Medicalbillersandcoders.com the largest consortium of billers and coders in the US, has also been helping several small to medium size dental practitioners with its Outsourcing services by helping them to develop proper documentation. By handling the new coding structure for them, we have spared them the trouble of learning the new code structure laving tem to spend more time on dental care.

Our service modules are flexible and it helps dental practices to choose only those parts of our services that they need help with avoiding going for entire service suite. So we can help those struggling to resubmit claims rejected for inaccuracies due to lack of understanding of ICD 10 resubmit their claims. Similarly, we can help you with coding your services excluding the other parts of billing and coding services.


Category : Dental Billing