Insurance billing and coding.
The purpose of this article is to highlight the importance of understanding various numeric and alpha-numeric codes for accurately billing dental and medically related services to private pay or third-party insurance carriers. In the United States, common dental terminology (CDT) codes are most commonly used by dentists to submit claims, whereas current procedural terminology (CPT) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD.9.CM) codes are more commonly used by physicians to bill for their services. The CPT and ICD.9.CM coding systems complement each other in that CPT codes provide the procedure and service information and ICD.9.CM codes provide the reason or rationale for a particular procedure or service. These codes are more commonly used for "medical necessity" determinations, and general dentists and specialists who routinely perform care, including trauma-related care, biopsies, and dental treatment as a result of or in anticipation of a cancer-related treatment, are likely to use these codes. Claim submissions for care provided can be completed electronically or by means of paper forms.
Napier
Rebecca H
RH
Department of Surgery, University of Kentucky, College of Dentistry, D-508, 800 Rose Street, Lexington, KY 40536-0297, USA.
Bruelheide
Lori S
LS
Demann
Eric T K
ET
Haug
Richard H
RH
D000067:Accounts Payable and Receivable; D003729:Dental Care / Q000145:classification; D003792:Dental Records; D003952:Diagnostic Imaging / Q000145:classification; D005376:Financial Management / Q000191:economics*; D005382:Financing, Personal / Q000191:economics; D005568:Forms and Records Control; D020408:Health Insurance Portability and Accountability Act; D006801:Humans; D007343:Insurance Carriers; D007344:Insurance Claim Reporting; D007347:Insurance, Dental / Q000191:economics*; D007349:Insurance, Health, Reimbursement / Q000191:economics; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics; D019647:Oral Surgical Procedures / Q000145:classification; D010339:Pathology, Oral / Q000145:classification; D010350:Patient Credit and Collection; D011215:Practice Management, Dental / Q000191:economics*; D009626:Terminology as Topic; D014481:United States