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NPM June Newsletter 2015

Wednesday, July 1, 2015

1) Code for Mandibular Orthopedic Repositioning Device used for TMD appliance (S8262) discontinued as of June 30, 2015

2) Study Group of the Month: Differential Diagnosis of TMD - learning by case studies with Dr. Mayoor Patel

3)  Medicare delays enrollment requirements

4) DentalWriter Forums Tip of the Month - How long do you have to file a medical claim after services are rendered to a patient?

5) DentalWriter How-To of the Month: Get rid of paper health history forms


Rose Nierman laid the foundation for dentists billing medical insurance when she wrote the first medical billing for dentistry manual, Successful Medical Insurance in Dentistry, 25 years ago. Over the last quarter century, Nierman Practice Management has led medical billing in dentistry with DentalWriter™ and CrossCode™ software and exceptional continuing education.  Contact Rose at 800-879-6468 or visit


Nierman Practice Management
221 Old Dixie Hwy #5

Tequesta, FL 33469

June 2015 Edition


Code for Mandibular Orthopedic Repositioning Device used for TMD appliance (S8262) discontinued as of June 30, 2015


Code S8262, Mandibular Orthopedic Repositioning Device commonly used for TMD appliances will be retired as of June 30, 2015. This code has been in the “temporary” code set of the HCPCS coding manual.  The Center for Medicaid and Medicare Services (CMS) reserves the right to revise codes without notice and has decided to retire the temporary code with short notice.

The quarterly HCPCS coding update file has been released on CMS’s website. One of the “discontinued” codes included in the update is S8262, standing for “Mandibular Orthopedic Repositioning Device, Each”. The discontinue date is at the end of the this month on June 30th, 2015.

You can download a copy of the coding update file on CMS’s website using the link below:

Download coding update files here


The discontinuation of S8262 is found on the “Other codes effective July 1, 2015” file shown below:


So what code do insurers want dental practices to use for a TMD appliance instead after June 30?

We did a search of medical policies for treatment of TMD and found the following codes related to TMD:

D7880 - Occlusal orthotic device, by report

D7889 - Unspecified TMD therapy, by report

21499 - Unlisted musculoskeletal procedure, head, by report

21089 - Unlisted maxillofacial prosthetic procedure, by report

The example below shows BCBS of MA's medical policy for Temporomandibular Joint Dysfunction and specifies that D7880 can be used on a medical claim (CMS 1500) with the appropriate TMJ Disorder diagnosis code as shown below:


You can view the full policy here

TIP: Pre-authorizations may need to be resent for treatment planned July 1 or later.


Study Group of the Month:

Differential Diagnosis of TMD - learning by case studies with Dr. Mayoor Patel


Enjoy the recording of this interesting and interactive session below. Dr. Mayoor Patel presents real patient TMD cases with their diagnosis outcomes - see if you can identify the issues on each case!

Medicare delays enrollment requirements

Medicare has announced a delay to the enrollment requirements for providers who prescribe Part D drugs to their Medicare patients. The new enrollment deadline is January 1, 2016.

The original deadline for providers to submit their enrollment forms (855i, 855o, or opt out affidavits) was June 1st, 2015. A week after the original deadline, Medicare update their website with the following language:

"Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Medicare Part D may no longer cover drugs that are prescribed by physicians or other eligible professionals who are neither validly enrolled, nor opted out of Medicare. All prescribers should enroll before January 1, 2016 to allow for the processing of applications and to ensure enrollees get their prescriptions."

Here is a link to the Part D prescriber information for Medicare:


Not sure if you are properly enrolled or opted out to meet the requirements for Part D drug prescriptions for your patients? Medicare provides great instructions on how to check:


DentalWriter Forums Tip of the Month

How long do you have to file a medical claim after services are rendered to a patient?

The short answer: this will vary from insurer to insurer!

The time frame that a practice has to file a medical claim after the date of service of the treatment/procedure is referred to as "timely filing requirements". The standard "rule of thumb" time frame seems to be between 6-12 months after the date of the service.

However, keep in mind - best practice is to always submit your medical claim as soon as possible after the services are rendered! The same day or the next day is always best (which is easy to do using the DentalWriter 4 Step process!)

The Medicare claims processing manual states:

"Medicare regulations at 42 CFR 424.44 define the timely filing period for Medicare fee for service claims. In general, such claims must be filed to the appropriate Medicare claims processing contractor no later than 12 months, or 1 calendar year, after the date the services were furnished."

But keep in mind, the timely filing requirement can vary! Take Horizon BCBS of NJ, for example. Their timely filing requirement state that the claim must be submitted within 180 days (almost 6 months) from the date of service, and correct claims within 365 days:

"Claims must be submitted within 180 calendar days from the date of service.

The claim will be denied if not received within the required time frames.

Corrected claims must be submitted within 365 days from the date of service."

So how do you know what the insurers timely filing requirements are? You can usually find it listed right on their website in the provider resources/manual or the claims filing information, or simply ask one of the representatives at the insurance company!

So what happens if you file a claim after the timely filing period? That will also vary from insurer to insurer!

Some insurers will simply deny the claim all together, and some insurer will charge you a certain percentage as a "late filing charge" but still go ahead and process the claim.

DentalWriter How-To of the Month

How does never having to print your health history forms for the patient to complete by hand again sound? Not mention not having to either scan or data enter the information on the back-end as well, creating additional unnecessary work.

With your DentalWriter Online patient forms, with ease and convenience you can eliminate paper patient medical forms and keep your schedule on track.

You can retrieve a copy of your unique DentalWriter Online hyperlinks that you can e-mail to your patient, add to your website, and/or bookmark on computers or tablets for patient use in your office easily within your DentalWriter Software. To do so, simply:

- Click the "Help/Training" menu on the main screen of DentalWriter
- Choose "Check for DentalWriter Updates"
- Click the "Check Status" button
- Click the "Send Online Form Links" button that appears
- A prompt will tell you what e-mail address the links were sent to. This will be the e-mail address that is registered to your DentalWriter software


From the e-mail you receive, you can click the link to the questionnaire form you are looking for, and even simply copy and paste that link into an e-mail to a patient.
Once the patient completes the form they do not need to email back to you! You can easily import all of the information into DentalWriter using your Online Forms Download Manager (the globe icon on the main screen of DentalWriter). Simply click the "Check Now" button to download any new questionnaire patient's have completed, or click the "Show Submissions" button to view any already downloaded questionnaire you have not yet imported. (downloaded questionnaires will wait in the download queue until you're ready to import them into your patient list).


Watch our training video that walks you through using and importing your patient's online questionnaire's below:

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