If you want to serve your patients and help them afford the treatments they need, it’s time to start using ICD-10-CM diagnostic coding in your dental office. Proper coding means that medical insurers may pay for your patients’ treatments. If you’re used to CDT codes and have never dealt with medical insurers before, using ICD-10-CM may seem like an intimidating change for you and your staff.
Here are a few simple steps you can take to jump-start diagnostic coding in your dental office.
1. Get training for a least one member of your billing team. Changing from the CDT to the ICD-10-CM is a major shift in terms of thinking, and your billing staff is the group most affected by the transformation. Schedule training for the people most likely to be dealing with the medical insurers. While some practices do try to self-teach, you’ll have a smoother transition and more effective billing if you begin the process with training for your team.
2. Explain coding to the rest of your staff. Diagnostic coding the language of medical insurers and medical doctors. By adopting it, your staff makes it possible to explain their work to a larger audience. This, in turn, will help your patients receive better care.
3. Emphasize the oral-systemic health link. The reason medical insurance pays for some dental procedures is because there’s a link between oral health and whole body health. If you teach your staff about this link, they’ll be more willing to take on the new tasks associated with medical diagnostic coding.
4. Revamp your intake appointments. If patients have medical conditions like pregnancy, diabetes, high blood pressure, heart disease or cancer, then their dental health can have an out-sized impact on their whole-body health. Take time at intake to get a complete medical history, since these conditions affect how you use diagnostic codes.
5. Talk to your patients about their health, and listen to what they have to say. Diagnostic coding is a way to tell a story to insurers. To bill medical insurers, you need to be able to show that a condition has real, negative effects on your patient’s life and health. For instance, if a patient’s dental problems are making it difficult or impossible to eat appropriately, that’s an important piece of the story. If a dental infection is also causing pain, or if there seem to be related sinus issues, those parts of a patient’s experience are important. Part of documenting medical necessity is documenting the suffering caused by a condition, and the only way you can get a sense of suffering is to ask questions and listen to what your patients have to say.
6. Train your hygiene team to spot and flag possible medical issues during hygiene exams. Your hygienists can be valuable partners in using diagnostic coding in your practice. Certain infections, bleeding gums, and sensitivities may be signs that a patient might be better served by ICD-10-CM coding than by CDT codes, especially if the patient has other medical conditions. A good hygienist will spot these issues and draw your attention to them, so that you can address them during your portion of the exam.
7. Use ICD-10-CM codes whenever possible. Learn the ICD-10-CM codes that are most likely to show up in your practice, and post a list in each patient bay. When you’re making notes during examination, write in any codes that might apply. That will help your billing staff apply the codes and bill medical insurance.
With these seven quick steps, you can quickly make the shift to ICD-10-CM coding and medical billing in your dental practice. The change will open new routes of treatments to your patients, since medical insurance will cover many treatment options in cases of infection, pain, or impacted ability to live a normal life. By implementing ICD-10-CM diagnostic coding and medical billing in your practice, you can continue to serve patients as an independent dental practice in a challenging environment.