Sample Two Day Program


Most dentists are under the misconception, for varying reasons, that medical plan benefits can only be accessed in cases involving trauma. This cannot be farther from the truth. Current medical plans on the market cover a wide variety of procedures, including examinations and consultations for such simple visits involving oral cancer screening, exams for minor issues like herpetic lesions, aphthous lesions, tori, Candidiasis and dry mouth, to more complex ones, such as atrophy of the alveolar bone and pneumatization(enlargement) of the sinus as a result of tooth loss. In addition, both surgical and non-surgical treatments of these, and a myriad of other infectious, inflammatory, and pathological problems are covered, including therapeutic (topical) treatments, periodontal surgical services, implant Stage I and II treatment, TMD, orthodontic and sleep apnea appliances, and oral and dental procedures related to traumatic injury.This two-day customized Presentation will discuss the different medical plans, the basics of medical diagnosis and procedure coding, as well as documentation requirements. Several claim examples for procedures commonly performed in the comprehensive dental office will be presented and discussed.


Participation: The program is geared to the Dentist and the Business Office Staff.Doctor attendance is mandatory, as successful reimbursement is dependent on the Doctor's input into the coding and billing process.
Handout:50 page Master handout provided for duplication.
The 2014 "Z Book", "Accessing Medical Benefits in the Comprehensive and Surgical Dental Practice" and accompanying CD will be included with the program (1 of each per participating office)
Program Length:Two Days (12 hours), includes a 2.5 hour workshop.
Program Honorarium:Just ask!


Part I:         Lecture          

(a)     Medical Insurance Overview
Patient history and clinical notes for medical billing
Pre-Authorization/Pre-Determination requirements
Phone pre-authorization for surgery

(b)     Medical Coding and Guidelines
ICD-9 (Diagnosis) Coding
CPT (Procedure) Coding
Documentation Requirements and correct formatting for medical billing


Part II:       Medical Coding Workshop

(a)        Claims Preparation
The CMS-1500 (02/12) Medical Claim Form
Claim Examples
Procedures covered include:
a. Examinations, Diagnostics
b. Common Emergencies
c. Therapeutic Treatments, including TMJ
d. Periodontal Surgery
e. Pathology/Excisions/Biopsies/Lasers
f. Implants- Stage I and II     
g. Sleep apnea
h. Trauma
i. Anesthesia/Analgesia/Oral Sedation

(b)     Hands-on Workshop         
Coding of Individual Cases provided by each office



*          Medical Diagnosis and Procedure Coding and Rules
*          The correct completion of the CMS-1500 (02/12) Medical Claim Form
*          Documentation required to support Medical Necessity