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Dental Office Manager Manual

ICD-10...Where To Find Help

Resources on ICD-10:

ICD Overview:

  • ICD means International Classification of Diseases.
  • ICD contains codes for diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.
  • ICD is maintained and updated by the World Health Organization (WHO).
  • Affects everyone covered by HIPAA, not just those submitting Medicare or Medicaid claims.
  • ICD codes were originally created for purpose of compiling mortality statistics.

Dental Implications:

  • Dental CDT codes tell what procedure was done. ICD-10 codes tell why it was done.
  • Dental providers will continue to use CDT codes for reporting procedures on dental claims.
  • The 2012 ADA Dental Claim Form has four blocks where practitioners can report ICD-10-CM diagnosis codes (see graphic below).
  • ICD-10-CM codes can be used on both dental and medical claim forms.
  • Most of the ICD-10 codes that apply to dentistry are on Chapter 11, Diseases of the Digestive System (K00-K95).
  • More and more states are requiring ICD-10-CM codes on Medicaid claims, and will reject dental claims that don't include the ICD code. The reason for rejection might not be clear that it was because of a missing ICD code. ICD codes are also required by some private third-party payors and ACA plans.
  • ICD codes can facilitate claims related to oral-systemic connection.

Where to enter the ICD-10 code on the dental claim form:

Different ICD Code Sets:

  • ICD-10-CM
    • It is a US national variant of the ICD, developed by CDCP in conjunction with NCHS.
    • Intended for clinical and outpatient medical coding and reporting.
    • Useful for physicians, dentists, and other health care providers.
    • Contains diagnostic codes.
    • Used in US since October 1, 2015.
    • CM stands for Clinical Modification
  • ICD-10-PCS
    • It is a US national variant of the ICD, developed by CDCP in conjunction with NCHS.
    • It contains procedure codes.
    • It is intended for inpatient hospital settings.
  • More free Dental Practice Management Free goodies:

    Dr. O's Dental Consultant Management Downloads 

    Dr. O's Dental Office Sample Letters

    Dr. O's Dental Insurance and Coding Documents

Written by Jacob Hodara


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