The implementation of ICD-10 codes will have a major impact on physicians and hospitals and an industry is sprouting up around preparing them for the 10/1/2014 start date. In November of 2012 I blogged that dental offices should prepare for a wider use of diagnosis codes. I still think this is good advice. Healthcare is headed toward more extensive sharing of information between care settings and the diagnosis code will become a key element to be shared.
In October of next year the ICD-10 will become the lingua franca of diagnoses. If a physician shares the medical history of a patient, expect to see these codes and be able to adjust your dental treatment according to what they are telling you.
But will you be using ICD-10’s to describe your services?
A look at the ADA’s 2012 dental claim form shows blocks “34” and “34a”, diagnosis codes and diagnosis code qualifiers. The form is ready both in its paper and electronic format. When do you use these two blocks and when can they be left blank? The phrase “required situationally” appears regularly in articles that speak to this.
What are these situations that would require the code? This depends on the patient’s insurance company. Many dental payers offer increased benefits for services associated with certain systemic conditions.
The increased benefit could include additional services or increased frequency in provided treatment.
Here is a page from our parent company’s website about just such a program. In order to access these benefits with a minimum of effort, having the appropriate diagnosis code on the claim will grease the wheels. Insurers may also allot increased benefits for complex services.
The ICD-10 code implementation will not have the impact on dentistry that it does on the medical side of healthcare but you will need to be familiar with the ICD codes in both their 9th and 10th iterations.
Watch for insurer’s programs that allow increased benefits for certain conditions and be sure you utilize these for the applicable patients.
Using the ICD blocks on the 2012 claim from will allow you to easily communicate this to the insurance company.
Familiarity with the new codes will allow you to better prepare for that patient whose health history says they suffer from R46.0, very low level of personal hygiene.
Preparation for this diagnosis would be a definite right click for you and the rest of your staff.
