8.16.13 Issue #597 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Belle DuCharme, CDPMA
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Dental Diagnostic Codes in the Future
Belle DuCharme, CDPMA

Dear Belle,
In conversation with a colleague, the question arose as to whether diagnostic codes are going to be required by 2015 on dental claims and in clinical records. Do you know the answer to this question?
Dr. Needtoknow

Dear Dr. Needtoknow,
Research is not giving me an exact date for this event to occur, but the following is a summary of my findings: In the 1990s the ADA started working on the first draft of SNODENT, its version of dental diagnostic vocabulary. It was supposed to be released in January 2000 but never came to complete fruition. The Harvard University School of Dental Medicine’s product EZCodes emerged to compete. One of them, unless others emerge, will be chosen as the standard for usage by the Department of Health and Human Services. Neither is ready for prime time according to Titus Schleyer, DMD, Ph.D., Associate Professor and Director, Center for Dental Informatics. Should you be prepared for future compliance? Yes - the day is coming that medicine is formally attaching the teeth to the rest of the body.

Dental condition diagnostic codes have been in the International Classification of Disease (ICD) but are now being updated and scheduled for completion by 2015 with the ICD-11 version. Diagnostic codes cover diseases, signs and symptoms, abnormal findings, complaints, social circumstances and external causes such as injury or disease. Dentistry has only been concerned with supplying treatment codes from the ADA’s Current Dental Terminology (CDT) on insurance claims.

To prepare for having to provide diagnostic codes to dental claims, start recording more detailed periodontal findings. At present the patient has health signified by a prophy, or periodontal disease signified by need of scaling and root planing or other treatment. The patient that is somewhere in between has been treated with a prophy. With the advent of diagnostic codes, many prophy patients will most likely be diagnosed with disease or at risk for disease. As with medical diagnostic codes, there will most likely be more dental diagnostic codes than treatment codes. There will be more treatment codes on the horizon because of the shades of gray in the standard of care in dentistry. A closer scrutiny of the patient’s health history and a higher due diligence in updating health history records will be in order. I have observed that many practices are lax in this area or allow the patient to dictate whether the health history is updated or not. Educating the patient on the importance of updated health history is the dentist’s prime responsibility to insure proper care and accurate record keeping. 

There is no doubt that how the dental practice manages dental records will change very quickly in the future. The current initiative to create electronic health records that can be accessed by all health care providers anywhere in the country through an interoperable system is making headway. According to the ADA: Scheduled for completion in 2015, the National Health Information Infrastructure (NHII) will be a communications system comparable to a network of highways, roads and pathways on which all health information will travel. Its purpose is to enable patients' electronic health records to be accessed and added to by all health care providers electronically (with patient authorization), virtually anywhere in the country, via the network. The electronic health record will include health information entered for a specific patient at a specific point of service. It will travel and be accessible on the NHII, the National Health Information Infrastructure. For updates on this evolving concern, go to the American Dental Association Website, www.ada.org.

This initiative is fueling the need for diagnostic codes in dentistry to be completed and used on future claims. Falling under the purview of the Department of Health and Human Services, HHS envisions regional collaborations among health care entities, including dentists and other health care practitioners, so that a patient's information can be securely stored in the local community and made electronically accessible to all health care providers involved in treatment of a particular patient.

Undoubtedly there will be more information coming out in the next year, including protocols for compliance. The digital age is here to stay, and being prepared is certainly better than sticking your head in the sand and hoping it will go away. If you are currently using a dental software practice management system, call support and ask if there is any news about how their system is being modified to meet the upcoming requirements.

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