When most of us think of medical coders, we think of those who use online databases such as those at Find-A-Code.com for hcpcs code or to search for CPT (Current Procedural Terminology) codes to translate patient files before they can be sent to billing. But coders are also necessary for dental practices, where their skills can be utilized to find the necessary CDT (Current Dental Terminology) codes for billing.
What are CDT Codes?
CDT codes are similar to CPT codes, but they cover dentistry and oral health. The codes are alphanumeric, and all begin with the letter ‘D’, followed by four numbers. The CDT code used will be determined by the type of service provided. They include:
- periodontics
- restorative
- diagnostic
- implant services
- endodontics
- orthodontics
- preventative.
The Benefits of Coders for Dental Practices
It is important that the proper dental coding is used to ensure prompt and accurate reimbursement from healthcare providers. This is where knowledgeable coders can be extremely useful. Their experience of coding can help them to ensure they are assigning the right codes to the type of service provided. Coders have been trained to be HIPAA (Health Insurance Portability and Accountability Act) compliant, which protects the practice from the consequences of unintentional violations.
Should Your Dental Practice Outsource Coding and Billing?
If you are running a dental practice, you might be wondering whether to outsource your coding and billing or hire someone to do this for you. The decision of whether to get a third-party company to take care of this part of the business will usually depend on your circumstances as well as the size of your practice.
If you have a larger practice, it might be beneficial to hire a team of coders and billers to work in-house, but smaller practices usually find that outsourcing coding and billing is ideal as it decreases workload and allows for more attention to patient care.
When another company is taking care of your coding and billing, you do not have to worry about office space. Nor do you need to think about hiring new staff when one person decides to leave. You can also forget about the costs and time associated with training coding and billing staff.
Using a third-party coding company means you can be sure that your coding is always up to date and following the latest guidelines. It is the responsibility of the coding company to stay on top of any changes made to policies and procedures implemented by the insurance providers. This means that you don’t have to worry about it.
A third-party company will be aware of the right codes to use based not only on the service provided but also on the type of insurance policy a patient has. For example, some dental procedures may not be covered under a specific plan, while some policies will cover certain aspects of the treatment and not others.
A patient must have dental cover for CDT codes to be covered by an insurance company. However, if the patient only has medical cover that does not include specific dental insurance, some dental services may still be covered if these are deemed medically necessary. This is something that an experienced coder will be aware of and as such why outsourcing coding can be a good idea.
Conclusion
Although coding and billing is typically associated with medical facilities such as hospitals and private practices, there is a need for coders and billers in dental practices too (although many of these practices will outsource this part of their business to third party companies to decrease workload and to allow them to focus on patient care).