CDT Codes for Dental Exams and the Importance of Insurance Verification

CDT Codes for Dental Exams and the Importance of Insurance Verification

A professional dental billing company in the USA, Outsource Strategies International (OSI) provides a comprehensive suite of dental billing services including comprehensive dental eligibility verificat ion. In today’s podcast, Amber Darst, one of our Solutions Managers, discusses the CDT codes for dental exams and the importance of insurance verification.

Podcast Highlights

00:19 CDT dental exam codes

01:24 Importance of Insurance Verification

02:15 Hire an Experienced Dental Billing Company

Read Transcript

Hi this is Amber Darst, Solutions Manager here at Managed Outsource Solutions and I’ll be discussing the importance of understanding the various CDT codes for dental exams and verifying the insurance plan frequencies for each of these codes.

00:19 CDT dental exam codes

Coding dental exams correctly on insurance claims is crucial for proper dental billing. There are several different dental exam codes and knowing what each of them mean and when to use them is necessary for proper billing and reimbursement. Here are a few of the most commonly used codes.

  • D0150 is a comprehensive oral evaluation and this is for new or established patients.
  • D0180 is a comprehensive periodontal evaluation and this is also for new or established patients.
  • D0120 is a periodic oral exam. This is for established patients and this code is most commonly used when coming in for regular cleanings and checkups.
  • D0140 a limited oral evaluation, problem focused and this code is typically used for emergency visits.

01:24 Importance of Insurance Verification

Another important thing to keep in mind is that often times these codes will share a frequency. What that means is if the patient has been recently seen another dental office or has even come into your office say on like an emergency visit and had a limited exam completed, their insurance may not pay towards another exam within the next so many days or even months according to their plans, rules and regulations. The best way to ensure that you’ll get paid properly for the services that you provide is to always complete a thorough insurance verification for each patient prior to their visit. This will give you the information to know whether the patient needs to pay upfront for the exam or when they would be next eligible for another exam through their insurance.

02:15 Hire an Experienced Dental Billing Company

Hiring an experienced dental billing company can get this very tedious and time-consuming task off your hands and allows you more time to focus on what’s most important – patient care.

And that’s all. Thanks for listening in.

Importance of Insurance Verification to Understand Different Dental Coverages

Importance of Insurance Verification to Understand Different Dental Coverages

Outsource Strategies International has years of experience providing dental insurance verification services for diverse specialties. We understand that, in the field of dentistry, verifying eligibility benefits for every patient before providing services is the key to maintaining a smooth cash flow.

In today’s podcast, Amber Darst, one of our Solutions Managers, discusses the importance of Insurance verification to understand different dental coverages.

Podcast Highlights

00:29 Insurers don’t always provide standard coverage

01:21 Significance of dental insurance verification

Read Transcript

Hi this is Amber Darst, Solutions Manager for Managed Outsourced Solutions and I will be discussing the differences and dental insurance coverages and how important it is to complete insurance verifications for each of your patients prior to their appointment date.

Along with the rapid changes occurring in dentistry treatments, dental insurance reimbursement rates and rules and regulations are also changing.

00:29 Insurers don’t always provide standard coverage

A few examples of how insurance plans don’t always provide standard coverage across the board is some plans have deductibles that are actually applied toward preventative service in addition to basic and major services, or there are some plans that do not count codes for cleanings and exams toward the plan’s annual maximum. And another big one that can affect reimbursement rates from plan to plan is some insurances won’t pay at the prep day, instead they reimburse based on the seat date or the completion date.

01:21 Significance of dental insurance verification

While such insurance challenges are just a part of the industry, dental providers should always strive to do all they can to ensure that the plan benefits are understood by both the patients and the staff. The best way to do this is to perform a thorough insurance verification on each patient before their date of service. By doing so, you will have a clear understanding of the patient’s coverages and you can then relay this information on to the patients, so that they know what to expect financially for any treatment that would be provided. Hiring an experienced dental insurance verification specialist will help keep this very important but time consuming task off your desk, leaving you to focus on what’s most important – patient care.

And that’s all. Thanks for listening in.

Importance of Verifying Dental Insurance Coverage For Porcelain Veneers

Importance of Verifying Dental Insurance Coverage For Porcelain Veneers

One of the leading dental insurance verification companies in USA, Outsource Strategies International provides comprehensive support to verify patient eligibility before the scheduled office visit. Information that is verified includes effective coverage dates, waiting periods, maximums and deductibles, treatment history, benefits used to date, type of plan and fee schedule, coverage percentage by category, implant and orthodontic coverages, and more.

In today’s podcast, Amber Darst, one of our Solutions Managers, discusses the importance of verifying dental insurance coverage for porcelain veneers.

Podcast Highlights

00:14 What are Porcelain veneers?

01:06 Importance of insurance verification

Read Transcript

Hi, this is Amber Darst, Solutions Manager for Managed Outsourced Solutions, and for this podcast I will be discussing the importance of verifying dental insurance coverage for porcelain veneers.

00:14 What are Porcelain veneers?

Porcelain veneers are one of the most effective dental options to improve the cosmetic appearance of your teeth and achieve the smile your patients’ desire. Veneers are a porcelain cover that is placed over the front surface of healthy teeth to improve their color, shape and appearance. Veneers cannot be used for restoring badly failing teeth. Dentists will likely recommend crowns instead, if the patients have any decay, cracks or excessive wear. Porcelain veneers are inexpensive dental restoration and insurance coverage is generally not available for veneers that are placed for cosmetic reasons. Although rare, there are instances where insurance will pay towards this procedure if it can be proven to be medically necessary.

01:06 Importance of insurance verification

Knowing each dental insurance company’s policies by performing a thorough insurance verification for each patient in advance of their appointment is crucial for dental practices to understand the coverage for veneers and crowns and it also ensures that you will get the proper reimbursement for any treatment provided.

Outsourcing your dental billing to MOS can help keep your revenue flowing, while you focus on providing patients with the best options for their needs.

And that’s all. Thanks for listening in.

CDT Coding for Gingivectomy

CDT Coding for Gingivectomy

Outsource Strategies International (OSI) is a competent provider of dental billing services. Our team helps practices submit clean claims with the correct CDT codes to meet payer guidelines. We also provide comprehensive dental eligibility verification services to confirm patient benefits before services are rendered.

In today’s podcast, Meghann Drella, a Senior Solutions Manager at Outsource Strategies International, discusses the dental codes for gingivectomy.

Podcast Highlights

00:11 Gingivectomy CDT Codes

00:54 CDT Coding Guidelines

Read Transcript

Hello and welcome to our podcast series. My name is Meghann Drella and I’m a Senior Solutions Manager here at Outsource Strategies International. Today I’ll be discussing the dental codes for gingivectomy.

00:11 Gingivectomy CDT Codes

The teeth in the mouth are divided into 4 quarters or sections. Let’s take a look at the CDT codes that describe your gingivectomy procedures and when each CDT code should be used.

  • D4210 for Gingivectomy or Gingivoplasty is four or more contiguous teeth or tooth bonded spaces per quadrant
  • D4211 is one or three contiguous teeth or tooth bounded space per quadrant

These procedures are performed to eliminate suprabony pockets, orto restore normal architecture when gingival enlargements are asymmetrical or unaesthetic topographically is evident with normal body configuration.

00:54 CDT Coding Guidelines

D4210 is covered when 4 or more teeth within a section meet the allowable criteria. D4211 is covered when 1 to 3 teeth within a section with the allowable criteria. D7971 is used when inflammatory or hypertrophied tissue is being removed on a partially affected or impacted tooth. D4274 can also be used for this procedure. This code does not include any osseous recontouring or removal and is used when the procedure is performed in an edentulous area adjacent to a tooth allowing removal of a tissue wedge to gain access for debridement and to reduce pocket depth. However, any benefit for this procedure will be disallowed when performed in conjunction with another surgical procedure in the same area. For instance, if bone removal is indicated or performed, D4261 should be used instead of D4274.

As coding for dental procedures can be really complex, a comprehensive dental eligibility verification to verify your patience coverage before the procedures are performed is very important.

I hope this helps, but always remember the documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

Thank you for joining me and stay tuned for my next podcast.

Billing and Verifying Insurance Benefits for Traumatic Dental Injuries

Billing and Verifying Insurance Benefits for Traumatic Dental Injuries

Outsource Strategies International (OSI) provides a comprehensive dental billing services and dental eligibility verifications to help you run your practice efficiently. Our revenue cycle management experts work to prevent denials, reduce your accounts receivables, and maximize your cash flow.

In today’s podcast, Amber Darst, one of our Solutions Managers discusses billing and verifying insurance benefits for traumatic dental injuries.

Podcast Highlights

00:16 Types of traumatic dental injuries

00:51 Relevance of accurate coding and eligibility verification

01:17 What does insurance verification involve?

01:48 Choosing an experienced dental billing company

Read Transcript

Hello, this is Amber Darst, Solutions Manager here at Managed Outsourced Solutions and for this podcast, I’ll be discussing billing and verifying insurance benefits for traumatic dental injuries.

00:16 Types of traumatic dental injuries

A direct external impact to the head sustained during scenarios such as sports accidents or falls can cause injuries to the mouth including the teeth, lips, gums,tongue and jaw bones. Accidental dental injuries caused by an external force occur most frequently in children and young adults, with the most common injury being a chipped or broken tooth. Some other types of traumatic dental injuries are a dislodged tooth, a lost tooth, crown fractures,and root fractures.

00:51 Relevance of accurate coding and eligibility verification

Accurate coding for claims filing and also knowing which insurance to submit to for these injuries is crucial. With the several various codes that are associated with the procedures performed to treat dental injuries along with certain medical plans providing additional coverage beyond dental benefits, practices should always perform a dental insurance verification before treatment is provided.

01:17 What does insurance verification involve?

This involves checking the patient’s insurance information by contacting the insurance company. In addition to verifying demographic information, the insurance verification specialist should check whether the patient’s policy covers the required services and if the services should be built only on a dental claim or if medical coverage also applies. They should also check if a preauthorization would be required for any major procedures.

01:48 Choose an experienced dental billing company

Consider a reliable dental billing company such as Managed Outsource Solutions to handle all of your dental insurance verification needs. Taking this task out of the office would be a major time saver for your front office staff, allowing them to focus on what’s most important — patient care.

And that’s all. Thanks for listening in.

Why Educating Patients on their Coverage is Vital

Why Educating Patients on their Coverage is Vital

Outsource Strategies International provides comprehensive dental eligibility verification services for General Dentists, Orthodontists, Periodontists, Endodontists, Prosthodontists, Oral Surgeons, Pediatric Dentists, and Dental DME.

In today’s podcast, Amber Darst, one of our Solutions Managers, discusses the importance of verifying patients’ dental insurance benefits and educating them on their coverage.

Podcast Highlights

00:16 Why educate patients

01:13 What role does insurance verification play?

01:54 How can an experienced dental billing company help?

Read Transcript

Hello this is Amber Darst, Solutions Manager for Managed Outsourced Solutions and I’ll be discussing the importance of verifying your patient’s dental insurance benefits and educating patients on their coverage.

00:16 Why educate patients

Patients with dental insurance are more likely to keep up with their regular dental checkups and follow through with the treatments when needed, rather than those who are uninsured. With this, most patients with dental insurance do not understand their coverage. Therefore it is extremely helpful and important to take the time to educate the patients on their benefits.

By taking the time to educate your patients, you can eliminate any confusion they may have about their coverage and also help avoid surprise bills. Some of the key points to discuss with the patients concerning their coverage are their maximum deductible, any waiting periods, coverage percentages for preventive, basic and major services, frequencies and limitations, and anything that may not be covered by their plans such as dental, cosmetic procedures.

01:13 What role does insurance verification play?

Obtaining this information to share with the patients first begins with completing an insurance verification. Making a call to the insurance carrier and asking thorough questions on each of your patients’ plans will help you understand the guidelines of their policy and allows you and the patient to be aware of the financial obligations before the patient’s appointment date. With the right information, patients will feel comfortable, valued and happy and can confidently go forward with the treatment they need. Insurance verifications can be a very time consuming task but are still important to complete.

01:54 How can an experienced dental billing company help?
Hiring an experienced dental billing company to handle this for you can prove to be a huge relief for your front desk staff, alleviating them of this task and allowing them to focus more on patient care.

And that’s all. Thanks for listening in.