Code revision requests for 2011 due Oct. 1
"This is how we communicate the procedures we perform to other dentists, third-party payers and government entities," said Dr. Alan Friedel, chair of the ADA Code Revision Committee. "It's supposed to be clear and concise. That's why we ask for submissions from dentists who believe the Code could be improved."
Requests to revise the Code (additions, revisions or deletions), are submitted by dentists and others in the dental community. There is no restriction on who may submit a request and each submission is presented to the CRC for consideration.
"CRC members review, discuss and debate each and every submission for months prior to the meetings," said Dr. Friedel. "As owners of the Code, the ADA takes the process very seriously, particularly as we prepare to transition into the electronic health record." (The Code is a Health Insurance Portability and Accountability Act of 1996 standard code set. Any claim submitted on a HIPAA standard electronic dental claim must use dental procedure codes from the version of the Code in effect on the date of service.)
Despite ADA ownership of the Code, dentists have to realize that change requests entirely supported by the ADA don't always make it into the Code.
"Tie votes will result in a failure to pass," explained Dr. Bert Oettmeier, incoming CDBP chair. "Because there are equal numbers of ADA representatives and payer representatives, ADA-backed code changes may not be approved."
The collection, review and meeting cycle occurs three times in each two-year cycle. The 12-member CRC committee was established in accordance with a 2002 agreement. Six CRC members are appointed by the ADA president each cycle and are current or past members of the Council on Dental Benefit Programs. Six more are appointed by third-party payer organizations.
After all requests are inventoried they will be sent to CRC voting members by Nov. 1, which marks the start of a 90-day review period before the February 2010 CRC meeting.
Detailed information on the CRC and the process, including the timetable and change request forms, is posted online at www.ada.org/goto/dentalcode. Questions about the process can be sent via e-mail to firstname.lastname@example.org or call toll-free and ask for the Council on Dental Benefit Programs. The direct dial number for nonmembers is 1-312-440-2500.