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Code Checker

Dentists unsure about codes have several options

It’s paperwork time.

You or your office manager have been there before. You’ve finished up with a patient and are ready to file a claim with their insurance company.

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You have this code for this procedure, that code for that procedure, but wait … are they right?

To make sure, there are a couple of options. The first and easiest one would be to consult your copy of Current Dental Terminology, which includes the Code on Dental Procedures & Nomenclature.

The most recent version of the CDT is from 2011-2012.

This handy book takes you through each code, providing descriptions and dividing them based on the type of procedure. It also has a section showing the changes to the Code from the last version.

The CDT 2011-2012 won an EXCEL Gold Award for Technical Book from the Board of Directors of Association Media and Publishing.

“In the back of the ADA’s award-winning CDT are both alphabetical and numeric indexes, which direct you to every reference about any particular code in the entire publication. This can be especially helpful, as one section of the CDT has more than 100 of the most common questions about coding, and these indexes will direct you to any such answers pertaining to the code you just looked up, whether by its name or number,” said Dr. Jim Richeson, chair of the Council on Dental Benefit Programs.

You can also easily download the CDT Code Check app on your iPhone, iPad or Android-powered mobile device.

This tool, which costs $19.99 and can be found in the Apple iTunes Store and the Android Market, contains a complete listing of every CDT code, including category of service, subcategory, procedure code, nomenclature and descriptor.

But maybe your copy of the CDT isn’t handy. Or it’s out of date. Or you don’t have a smartphone. Or maybe you’re just unsure.

There’s another easy solution: call the American Dental Association.

Staff members in the dental benefits area are trained to help ADA members figure out which code they should assign to which procedure.

Dental benefits staff can also help members who are confused about procedure codes not being covered under a patient’s policy or procedure codes that are no longer valid. Staff can also help members understand nuances that might be helpful when deciding how to code a procedure.

“Staff who work in the ADA’s dental benefits area live and breathe the Code. They understand ins and outs of the CDT and can typically assist callers rather quickly on their needs,” Dr. Richeson said.

“They also appreciate the complexity of assigning codes to procedures and understand the patience they must have when trying to help a member who may be confused about how to file a claim. But that’s what they’re there for, to help.”

The hard copy CDT 2011-2012 (J932) sells for $49.95 to members and $79.95 for nonmembers. The electronic version (J932D) can be purchased for $39.95 for members and $59.95 for nonmembers.

For Code questions, call the ADA’s toll free number, which can be found on the back of your membership card, or email dentalbenefits@ada.org. To purchase the latest version of the CDT, visit adacatalog.org or call 1-800-947-4746.