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As documentation linking oral health and overall health of the human body continues to build, more and more dental practices are recognizing the value of filing medical claims for many of their procedures. Incorporating medical billing in dental practices has turned out to be a win-win situation for everyone. Here is a current list of dental procedures that can and should be filed with medical carriers:
• Trauma procedures
• Medically necessary oral surgical, laser, and periodontal procedures
• Medically necessary implant, endodontic, and prosthodontist procedures
• TMD procedures
The following example illustrates how dental practices and their patients can reap the benefits of this billing process: After a nonsurgical periodontal treatment was done on a patient with the medical diagnosis attached, the office that performed the service billed both dental and medical insurance. Staff members were amazed at the number of cases that met the criteria for filing a medical haskayne career link claim. While some similarities exist between preparing a dental claim and a medical claim, such as patient demographics and insurance demographic sections, there are also some significant differences, such as in coding systems. Medical carriers also require the reason (which is the patient's diagnosis) why the particular procedure was done. Therefore, medical necessity is probably the most important element of successful dental-medical cross coding.
Dental practices that choose to implement a dental-medical cross-coding system will undoubtedly experience a positive impact on their day-to-day operation.