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Are You Prepared For Upcoming Mandatory Medical Billing Changes?

Friday, March 28, 2014

documentation You may notice that the old claim form looks very similar to the new claim form at a glance. There are important changes you need to be aware of!
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documentation Nierman Practice Management will ensure DentalWriter users are all up to date prior to the mandatory changes being implemented.
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documentation ICD-10 is NOT just CrossCoding from ICD-9! Detailed documentation is more important than ever!
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      Friday, March 28, 2014  

Are You Prepared For Upcoming
Mandatory Medical Billing Changes?



Nierman Practice Management is getting dental practices ready for 2014 medical billing changes with their popular DentalWriter™ and CrossCode™ software systems. Many procedures performed in a dental office may be considered by medical insurers as “medically necessary”, and thus billed to medical insurance instead of dental. Some treatments which may be covered by medical insurance include temporomandibular joint (TMJ) disorders, sleep apnea mouth guards and oral surgery services.

The changes include the new diagnostic coding set and new medical claim form, both scheduled to take place in 2014. These changes are required for anyone covered by HIPPA. It’s important for dentists to be aware of the major changes on the horizon in medical billing in order to avoid lapses in reimbursements from health insurers.
You may notice the old claim form (CMS 1500 08/05) looks very similar to the new claim form (CMS 1500 02/12) at a glance. In fact, they are very similar! There are important changes you need to be aware of! 
The biggest change on the new claim form is the inclusion of eight additional areas for healthcare providers to list diagnosis codes associated to the claim. The current version only allows four spaces per claim to list related diagnosis codes. Other fields have been removed or changed as well. For example, the new claim form will no longer ask for marital status, employment status or the insured’s employer/school name.
ICD-10 claim form
Nierman Practice Management will ensure DentalWriter users are all up to date prior
to the mandatory changes being implemented.    

 As far as the diagnostic codes are concerned, they are set to change to ICD-10 on October 1st, 2014. ICD-9 is the current diagnostic coding system in effect. The diagnostic coding system contains codes for identifying: diseases, signs & symptoms, abnormal findings, complaints and causes of injury/disease. It is important for physicians, dentists and other healthcare providers to understand that ICD-10 is not simply the ICD-9 renumbered. The ICD-10 is a completely new coding set that is organized differently to allow for more flexibility and accurate diagnosis reporting.

The ICD-10 coding set allows for over 14,000 different codes and expands to over 16,000 with use of optional sub-classifications. For example, ICD-10 codes allow 3 to 7 characters for a diagnosis code whereas the ICD-9 only allows 3 to 5 characters. These changes to the diagnostic coding system do not affect the CPT or HCPCS coding systems which identify procedures, professional services, equipment and supplies.
happy lady
ICD-10 is NOT just CrossCoding from ICD-9!
Detailed documentation is more important than ever!

The reason for the increase in codes for ICD-10 is to allow for greater specificity when making a diagnosis. Gone are the days of using an ICD-9 code as a general description of a diagnosis. The new documentation requirements mandate a much higher level of detail when using diagnostic codes. Here is an example of the specific information the ICD-10 coding set documentation requires in the case of an accident. (please note this is an example and the information is not limited to the items below)

  • The description of the cause of the accident
  • Initial encounter only – the activity that the person was doing when the accident occurred
  • Specific injuries at the time of the accident, and then at the time of the encounter
  • The actual location the patient was in during the accident (each room in a house has it's own code)
  • If the patient lost consciousness due to the accident or not if a concussion is diagnosed
  • If headaches are associated with an accident, detailed descriptions of relief or non-relief need to be noted
  • Acute or chronic needs to be noted as well.
DentalWriter documentation

The DentalWriter™ Software allows you to simplify the documentation process in your
dental practice in 4 easy steps, so you can concentrate on what matters most, patient care!

DentalWriter 4-step process
View a Short Demo of the DentalWriter™ Software 4-Step Process

Request a live demo
of the DentalWriter™
Software now!

“DentalWriter saves time on medical claims processing and tracking, and online patient registration, and medical recordkeeping for sleep apnea. Nierman Practice Management has provided an excellent product which we use every day as part of our sleep apnea/oral appliance practice. It is a huge time saver.”

- Robert A. Levy, D.M.D., St. Louis, MO


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