Course Synopsis
Many dentists are under the misconception, for various reasons, that medical plan benefits can only be accessed in cases involving trauma, but this cannot be further from the truth. Current medical plans on the market cover a wide variety of procedures, ranging from simple examinations and consultations, such as oral cancer screenings and exams for minor issues like herpetic lesions, aphthous lesions, tori, Candidiasis and dry mouth, to the more complex, such as atrophy of the alveolar bone and pneumatization (enlargement) of the sinus as a result of tooth loss. In addition, both surgical and nonsurgical treatments for these and a myriad of other infectious, inflammatory and pathological problems are medically covered, including therapeutic (topical) treatments, periodontal surgical services, Stage I and II implant treatment, TMD, orthodontic and sleep apnea appliances, and oral and dental procedures related to traumatic injury.
This two-day presentation will discuss the different medical plans and the basics of medical diagnosis and procedure coding, as well as the associated documentation requirements. Many claim examples for procedures commonly performed in the comprehensive dental office will also be presented and discussed. A supervised workshop component, during which participants will code their own patients' procedures and surgeries, concludes the course.
Course Objectives
After completing this course, the dental professional should be able to:
- Understand medical diagnosis and procedure coding and rules.
- Correctly complete the CMS-1500 (8/05) Health Insurance Claim Form.
- Identify the documentation required to support medical necessity.
Additional Course Information
This course is geared to the dentist and the business office staff. Surgical assistants are also encouraged to attend. Doctor attendance is mandatory, as successful medical reimbursement is dependent on the doctor understanding his or her role and giving input into the coding and billing process. Billing team members cannot prepare documentation and/or claims without the doctor providing the information needed in the correct format for medical billing.
A 50-page handout is included in the course fee. Attendees will also be able to purchase Dr. Zahrebelny's 2012 medical billing manual for dentists, "Accessing Medical Benefits in the Comprehensive and Surgical Dental Practice," and optional CD that includes templates for letters of medical necessity, operative reports and appeals.
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Dr. Olya Zahrebelny graduated in 1978 from the Faculty of Dentistry at the University of Toronto, Canada, and completed a general practice residency focused on oral surgery, oral medicine and oral pathology. She has practiced in hospital and private practice environments for the past 32 years and is a principal in health care practice management company The Z Group. A former consultant for commercial and government insurance programs, Dr. Zahrebelny taught at Northwestern University Dental School and was an attending physician at the University of Illinois Medical Center. She has been a columnist for Dental Economics and Dental Equipment & Materials, and a featured columnist for Insurance Solutions. Named a leader in continuing education and dental consulting by Dentistry Today, Dr. Zahrebelny has lectured throughout the U.S. and internationally at dental meetings, for dental societies, study clubs, continuing education programs, and hospital residency programs.
