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Get Ready—Get Set New CDT Codes EVERY YEAR!

 

Get Ready—Get Set
New CDT Codes
EVERY YEAR!

by Roz Fulmer

Were you aware that in September 2011 the ADA replaced the Code Revision Committee (CRC) with the CAC (Code Advisory Committee)?  I am happy to share with you that this great change did happened and that the new 21-member committee is moving forward beginning with the codes and revisions January 2013.  The 21-members will consist of the following members:
Five representatives from the ADA.
One representative from the nine recognized dental specialty organizations.
One representative from each of the following third-party payer organizations: Blue Cross/Blue Shield Associations, Delta Dental Plans, Centers for Medicare and Medicaid Services, National Association of Dental Plans and America’s Health Insurance Plans.
One representative from the American Dental Education Association and
One representative from the Academy of General Dentistry.

Why the change to every year instead of every two years is due to the federal law of HIPAA that requires dentists and the third-party payers to only use current codes and we, the dental practices of America will need to be learning the CDT codes changes on a yearly basis.  Remember, we will need to know these changes prior to January of the New Year because that is when the codes will go into effect.

Here are a few of the many exciting revisions for January 2013:  Description for D2740 will include for Lava/CEREC crowns.  The descriptor will read; Porcelain/ceramic restorations will include “pressed, polished, or milled materials containing predominantly inorganic refractory compounds – including porcelains, glasses, ceramics and glass-ceramics”.   REMEMBER, this does not go into effect until January 2013.  If you are using this code right now for your CEREC/Lava crowns, you MUST include a narrative on the claim form in the Remarks box #35.

Another revision already in place pertains to code D9630 other drugs and/or medicaments by report.  When and what time of “drugs/medicaments” should this code be used for in your dental practice?  TODAY, this code should be used when dispensing for “home use only”, not within your office.  Example:  At times a patient was given in the office an oral antibiotic to prevent endocarditis and an office may have coded out D9630 for giving this medication to the patient within the office.  TODAY, that code could only be used if the patient were given the medication to use “at home, not in the office”.  Other medicaments patients may be given to use at home would be over-the-counter Fluoride (PreviDent, Fluoridex), oral analgesics, chlorhexidine mouth rinses (Peridex, PerioGard, etc.), MI Paste, etc.  This code is rarely reimbursed and should always have a narrative as to “why and what” was given for “take home usage”.

What code are you using for a “chipped” tooth, “smoothing teeth”, “reshape a root”, or “an orthodontist asked to you to reduce the mesial and distal surfaces of either primary or permanent teeth?  D9971 odontoplasty 1-2 teeth includes removal of enamel projections.  This code is used for adjusting up to 2 teeth and if more teeth were adjusted then you need to submit the code more than once stating which teeth were treated.  Typically, this code is only covered by plans due to accident related scenarios, not for cosmetic purposes.  You can charge out a D0140 Limited Evaluation if these teeth were not previously diagnosed along with D9971.

What is your plan for getting your entire team up-to-date on the newest CDT codes plus revisions in 2013?  Have you ever had an “Insurance Expert” present a Hands-On course right in your office?  That is exactly what I do on a weekly basis all across the United States, training right in your own office, training your team to be experts for your patients.  How well is your team trained in the areas of insurance coding?
Here are a few of the topics covered throughout my training session with you and your team:
The Real Wealth of Examination Codes
Self Funded Plans vs Fully Funded Plans
Coding Compliance – Dental vs Medical
Maximizing CDT codes for $$$ Benefits for your Practice
Narratives for Most Dental Procedures
Enduring and Passing an Audit

That is just the “tip of the iceberg” as they say to all the new changes that are coming your way very shortly in regards to CDT Insurance Codes.  Is your office ready for these changes?  If not, give me call 815-481-3851 to schedule a training day right NOW!
FREE downloads at my website: www.rozfulmer.com.

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