Diagnostic Coding and Medical Necessity

Electronic Health Records (EHR) is not a new initiative; it has been an ongoing effort for decades. Dentistry became specifically involved, when on April 27, 2004, then-President Bush called for the majority of Americans to have EHR within 10 years and signed an Executive Order. This order included dentistry based on the information provided in David Satcher, M.D., Ph.D. then-Surgeon General, first ever Surgeon General's Report on Oral Health in May 2000. The American Recovery and Reinvestment Act (ARRA) was signed into law by President Obama on February 17, 2009. Part of that law included the Health Information Technology for Economic and Clinical Health (HITECH) Act to further promote the adoption and meaningful use of health information technology. There are multiple benefits projected when all of this comes to full fruition. Dentistry is not ready for interoperability based on current coding. For dental records to interface with other healthcare records there needs to be diagnostic coding systems. Diagnostic coding involves all part of the team including clinicians.

Billing medical insurance for oral health procedures that are medically necessary leaves dental benefits available. Cutting edge dental practices that implement cross coding have happier patients who can better afford their medically necessary dental treatment which can result in increased practice profitability due to a higher level of case acceptance. Embracing medical cross coding also brings dentistry further into the medical world by speaking the language of medicine.

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