Dental Coding Challenges & Solutions to Overcome Them

Medical billing is an intricate and delicate field that requires huge accuracy and precision. Dental billing and coding is a branch of medical billing that requires a higher level of accuracy and precision. It is very vital for successful claim filing and accurate reimbursement. The practitioner always focuses on providing the best patient care they can provide. However, the administrative aspect, mainly billing and coding, can become a setback for them.

Simplify the Complexity of Dental Coding

Dental billing and coding are more than just administrative tasks. These are important elements of the revenue cycle which makes sure that the providers are getting reimbursed for all the services rendered.

However, just like any other medical billing, the complexities and frequent updates make it difficult to maintain a healthy revenue cycle. In this blog, we will go through the errors and the strategies used to overcome these errors.

First Let’s Go Through Some Common Dental Coding Errors

Fluoride Codes:

After the transition of old fluoride codes to the new ones, many practitioners still use outdated codes which results in huge losses

Limited Oral Assessment

Incorrect use of evaluation codes during emergency visits and underutilizing palliative treatment codes can lead to lower or no reimbursement.

Incorrect Information

Even minor errors such as misspelled names or incorrect patient information will leave a significant hole in your reimbursements, leading to delayed or denied reimbursement.

Upcoding or Undercoding

If a practice uses a code for an expensive procedure or for a less expensive one, it is an unethical practice that will lead to severe repercussions.

Outdated Codes

The CDT codes are updated by the American Dental Association every year. Using these codes will result in rejected and denied claims.

Strategies to Avoid Errors

Stay Updated

Regularly update and review your knowledge of the latest coding guidelines which ensures accurate coding and billing.

Review Bills for Accuracy

Create a robust and reliable review process to catch any errors before submitting the claim. This reduces the risk of denials and delays.

Regular Staff Training

Healthcare practices must invest more towards the training of their billing and coding staff and keep them updated about the latest coding guidelines.

Stay Informed About Updated Codes

The dental codes are updated once a year by the American Dental Association. Stay updated about these updates by subscribing to ADA publications and attending their webinars.

Clear Documentation

Create detailed and clear documentation of every procedure. The records support the use of specific codes which can be very useful in case of a random audit.

Ethical Coding Practices

Focus more on the importance of ethical coding practices with your staff. Make sure they understand the legal consequences of upcoding, and undercoding.

Now that we have learned a bit about the errors and the ways in which one can reduce them, lets understand the challenges of Dental Billing.

Major Challenges of Dental Billing

Time Constraint

If a practice has high footfall with insufficient administrative support, this might give rise to problems, especially if the tasks are done manually. Under these situations a practice can really benefit from dental billing services provided by a dental billing and coding company.

Their expertise can speed up the claim process without the need for you to assign tasks to your staff. This gives your practice enough time to focus solely on patient care.

Following Claim Guidelines

It is important to follow a tight processing criterion decided by the insurance company and government regulations. If anyhow your practice fails to follow these guidelines, your claims will be rejected for sure. The consequences can be more fatal than just rejection.

Coding Updates

Though this factor has played a crucial role in errors it is also a very big challenge because these frequent changes can be missed very easily. It is totally out of your control, and you will have to be very proactive with the billing issues.

As new materials and techniques come up in dental healthcare, the codes will change according to the material or technique used. This is enough to bring any expert practice to their toes. Every practice must stay ahead of the guideline changes as this will significantly interfere with their revenue cycle.

Lack of Follow-Up

If you do not have a follow-up system in your practice, you will have a lot of patients walking out without clearing their dues. A major part of the dental patients are covered by one or more insurance policies. This makes collecting the claims difficult.

When the dentist comes to know about the same, they start taking pressure and work overtime. This is not a good practice because your collections will still be poor as more and more people will file unverified insurance or pay late. This is the same as a denied or delayed claim.

Collection of Copays

Copayments are the payments made in advance for the services that are being provided by the healthcare practitioners. If somehow, the provider does not receive the full amount in the beginning, there are high chances that they will have difficulties in obtaining the remaining payment.

That is why it is beneficial and convenient for the provider as well as the patient to receive the payment before the services are rendered.

These obstacles, if not addressed, can hamper the collection rate of your practice. The patient might get the treatment if the physician wishes to, but ultimately their practice will be at the suffering end.

Common Dental Medical Billing Codes

D0419: Evaluating Salivary Flow by measurement

D2753: Titanium or titanium alloys crown

D5284: Removable unilateral partial denture, one-piece flexible base (with clasps & teeth), per quadrant

D5286: Removable unilateral partial denture, one piece resin, per quadrant

D6082: Implant supported crown; porcelain mixed with base alloys

D6803: Implant-supported crown; porcelain mixed with noble alloys

D6084: Implant-supported crown; porcelain mixed with titanium alloys

D6086: Implant-supported crown, made of base alloys

D6087: Implant-supported crown, made of noble alloys

D6088: Implant-supported crown, made of titanium alloys

D6120: Implant-supported retainer, porcelain fused to titanium and titanium alloys

D6121: Implant-supported retainer for metal FPD, predominantly base alloys

D6123: Implant-supported retainer for metal FPD, titanium and titanium alloys

D6195: Abutment supported retainer; porcelain mixed with titanium alloys

D6243: Pontic, porcelain mixed with titanium and titanium alloys

Overcome Dental Billing and Coding Challenges with Unify Healthcare

Dental billing and coding are a hectic task on its own. The complexities are added to it due to various coding and guideline changes. Making sure that all the guidelines are met is a huge need for accurate reimbursement.

The best way to do this is to take dental billing services from professionals such as Unify Healthcare Services.

Unify Healthcare Services is a well-regarded dental medical billing with a list of numerous satisfied clients. It has some of the best billers and coders on their team who are always up to date about the most recent provision updates. This ensures that all your claims are filed accurately and are submitted on time for accurate reimbursement. This takes off a huge load from your shoulders and gives you more time for patient care. Yor staff will have all the time to attend the patients and help them in the best way possible.

Partnering with Unify Healthcare Services gives you peace of mind, which ultimately improves the footfall and increases the revenue. In the end, it turns out to be fruitful for both the patients as well as the providers.