Increase Dental Practice Revenue: Avoid Coding Errors and Practice Pitfalls


Everyone desires to receive fair compensation for their hard-earned efforts. However, inaccuracies in coding and other procedural missteps can inadvertently diminish your earnings. Explore these strategies to boost the revenue of your dental practice.

Have you noticed that you’re putting in extra hours but not seeing a corresponding increase in pay? Imagine working 10 hours but only being compensated for eight. Is this a situation you’d like to rectify?

Consider, for a moment, how many hours per week you allocate to direct patient care. According to staffing experts at indeed, it typically ranges from 35 to 40 hours.1 This encompasses all aspects of patient care and related responsibilities. Yet, what about the additional crucial tasks essential for developing your dental practice?

If you’re a practice owner, you bear administrative responsibilities that go beyond direct patient care. When managed effectively, these duties can lead to an upturn in practice revenue. Meticulously detailing patients’ primary concerns and accurately coding treatment plans tailored to their needs demands extra time and concentration, but it ultimately results in a more comprehensive approach.

In the midst of their demanding schedules, busy dentists sometimes bypass crucial steps in documenting the clinical services provided to patients. They might employ cryptic shorthand that, while familiar to them, falls short of meeting legal documentation standards. Moreover, dental codes are at times misused or not fully utilized, resulting in both lost revenue and valuable time.

The habit of saving time by omitting necessary documentation can potentially lead to a loss of future revenue and increase the risk of an insurance audit. Thorough documentation stands as your primary defense if a patient lodges a complaint that requires review by your peers. Consider this: can you accurately recall a diagnosis or treatment you provided if it isn’t documented? Would your memory serve as a reliable record weeks or months down the line? The recollection of a past event doesn’t constitute a credible record

You may also find intriguing: An in-depth exploration of medical billing.

Tip 1: Minimize Administrative Tasks That Hinder Revenue Generation

Empower appropriately trained team members, such as insurance coordinators, licensed or certified dental assistants, or licensed hygienists, to handle certain administrative duties within the boundaries of the law. Competent staff members can double-check the schedule and ensure the accuracy of proposed charges and codes before finalizing them on the ledger.

Other team members can take responsibility for validating clinical notes and treatment plans, as well as ensuring that informed consents are in place. Whether clinical or business-oriented, team members can confirm that insurance verification is documented in the patient’s chart prior to treatment and has been discussed with the patient.

A pivotal aspect of bolstering revenue through administrative means is providing comprehensive staff training. Areas of focus should encompass clinical charting, coding proficiency, accurate documentation, and adept selection of pertinent attachments, thereby relieving the dentist of this responsibility.

Integrate electronic health records and other software tools to streamline the documentation and Medical billing processes, steering clear of the pitfalls associated with paper-based or dual-entry systems. Dedicate a specific time of day to concentrate on administrative tasks and minimize disruptions. This approach will help prevent a backlog of record-keeping from accumulating over days or weeks.

Tip 2: Dental Records Serve As a Safeguard against Financial Risks

The dental record serves as the official and legally binding document encompassing diagnostic details such as the primary complaint, clinical notes, patient medical history, observations, services provided, and patient interactions. This record is crucial in accurately capturing a patient’s encounter, ensuring comprehension and recognition not only by fellow healthcare professionals and insurance entities but also within a legal context. Healthcare providers adhere to the maxim, ‘If it’s not clearly documented, it didn’t occur.’

Comprehensive supporting documentation is indispensable in preventing audits and facilitating the settlement of claims. The proper coding of procedures begins with thorough clinical charting of the patient’s concerns and conditions. When submitting insurance claims for third-party reimbursement, bill for the services actually rendered and utilize codes that precisely match the treatment description, rather than prioritizing those likely to yield higher payments. Maintaining accurate, legible records safeguards against allegations of fraud and malpractice. It’s worth noting that electronically submitted insurance claims are legally protected by HIPAA and state laws.

Incorporate CDT coding and the use of ICD-10 diagnostic codes as standard practice in your treatment plans. Familiarity often plays a role in selecting codes that accurately represent the services provided. Be mindful that some newer codes, which may be pertinent, are sometimes overlooked due to a lack of awareness about their existence.

Remember, CDT codes serve to document services provided to patients; they aren’t solely for billing purposes with insurance companies. Keep in mind that CDT codes undergo annual updates, and choices made in the past may now be obsolete or require revision to align with the current situation.

Note: Ensure that on a daily basis (delegating as necessary), all providers have completed their clinical notes, backed by supportive documentation, as well as the organization of x-rays and images, appropriately labeled and stored within the patient’s chart in your software. Failure to do so may hinder the filing of claims, leading to delays, denials, and subsequent revenue loss

Tip 3: Stay Informed About the Current CDT Codes And Their Impact On Productivity

Improper or underutilized dental codes lead to both financial losses and wasted time. Invest in updated coding manuals before the commencement of the New Year. Make sure to incorporate coding updates into your morning huddles, staff meetings, or lunch and learns.

Consider subscribing to coding resources that not only furnish the complete codes as per ADA guidelines but also offer guidance on their accurate application and the strategic combination of codes to enhance records and align with provided services.3 Simply updating your computer software won’t suffice, as it may not provide comprehensive descriptions for each code or offer advice on selecting codes that best match the treatment.

Below are examples of frequently submitted procedures that may be denied by dental plans due to inaccurate, incomplete, or insufficient clinical evidence:

  1. D7250 – Removal of residual tooth roots (cutting procedure): This includes soft tissue and bone cutting, tooth structure removal, and closure. The clinical notes and supporting documentation must clearly demonstrate the cutting of soft tissue and bone, as well as proper closure.
  2. D2950 – Core build-up, including necessary pins: This pertains to the reinforcement of coronal structure when separate extra-coronal restorative work lacks adequate retention. It’s important to note that a core build-up isn’t filler to correct undercutting, box form, or concave irregularities in a preparation. The procedure must demonstrate its purpose for crown retention. If the procedure isn’t for crown retention and doesn’t involve any pins, then code D2949, representing the restorative foundation for an indirect restoration, would be the appropriate choice.
  3. D4342 – Periodontal scaling and root planning for one to three teeth per quadrant: This treatment is intended for patients diagnosed with periodontal disease and is therapeutic, rather than prophylactic. It’s crucial to thoroughly review and understand the complete scope of the code descriptor before listing this procedure on a claim form. Dental plans have indicated that a common reason for SRP claim denials or requests for additional information is the submission of radiographs lacking diagnostic quality, with no evidence of attachment loss, and substandard periodontal charting that doesn’t cover six points around each affected tooth.

Underutilized Codes in Dentistry

Inadequate use of codes often stems from a lack of knowledge. Consult the 2023 coding manuals for comprehensive descriptions and applications.2

  1. D3221 – Pulpal debridement for primary and permanent teeth.
  2. D1354 – Application of caries arresting medicament, per tooth.
  3. D2940 – Protective restorations aimed at alleviating pain, fostering healing, and preventing further deterioration.
  4. D2799 – Interim crown, requiring further treatment or completion of diagnosis before final impressions (not a temporary crown).

A medical coding expert emphasizes, ‘Accurate coding frequently leads to increased revenue, as practices receive reimbursements that were previously left unpaid due to misunderstandings or misreported codes.’3 Involve the entire team in proper documentation and coding practices to collectively benefit from heightened revenue and superior dental records.”

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