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Treating the Common Code Part 1

Friday, June 16, 2023
7:30 AM – 9:00 AM PST
Location: Room 4C1-C2
CE Credits: 1.5
Primary Audience(s): Hygienist

Additional Audience(s): Dentist, Front Office
Accurate, evidence-based diagnosis is the best method to determine appropriate treatment. Once this diagnosis is determined, the clinician will develop a treatment plan. This includes selecting the correct CDT procedure codes for the treatment. Too often, the procedure code selected may be inaccurate because dental software programs ONLY include the code number and title, NOT the descriptor.

Many clinicians are unaware of the ADA’s Current Dental Terminology (CDT) descriptors for each procedure code which must be used by the business staff to correctly bill patients and their insurance carriers. Inaccurate billing can often result in patients having to pay more out-of-pocket dollars then they were expecting to pay which then can lead to mistrust. This can further lead to patients refusing to have ANY treatment completed because they cannot believe the “estimate” which they were given.

As technology and treatment modalities evolve, new CDT procedure codes are developed, and current CDT procedure codes are amended by the ADA’s Code Maintenance Committee (which meets every March). This course will provide the latest nomenclature and descriptors for procedures which can be performed by dental hygienists. For example, in Washington state alone there are over 95 codes for procedures performed by dental hygienists.

And what about the ICD-10 Diagnostic Codes (over 700 of them) listed in the current CDT Procedure Codes Manual? How and why do we need to know these? So many questions!

Learning Objectives:

  • Describe the various parts of the CDT procedure codes and why it is important to understand the descriptors.
  • Explain the definitions and descriptions of the CDT Procedure Codes for Evaluations, Preventive Services, and Periodontal Therapy as they relate to dental hygiene procedures.
  • Discuss the basics of “Dental Insurance 101” and explain why dental "insurance" is NOT really insurance at all.
  • Describe how the dental "insurance" industry determines how it will reimburse various dental procedures (or not reimburse them).
  • Describe the various verbal strategies for communicating with patients about their need for preventive, periodontal or restorative treatment.
  • Explain why "creative" billing of dental procedures to a dental "insurance" carrier can potentially lead to risk management issues for the dental practice.