#915: Tips + Tricks to Make Coding Exciting (and Accurate)

Dental A Team Podcast

Tiff and Dana discuss the importance of coding accuracy in dental practices. That includes universal codes everyone can understand, how to stay up-to-date on resources, the best way to know team members are getting paid for all their work, different codes across specialties, and more.

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Transcript:

The Dental A Team (00:01.11)

Hello Dental A Team listeners, we are back at you today. I have the one and only Miss Dana here with me to podcast. I love pulling Dana in. I love pulling all the consultants in, but I truly love pulling in Dana. think I shouted you out this morning. do. Wednesday core value shout out in our.

I know that we've done some podcasts on that. So if you're not already doing a core value shout out every day or every week, please by all means go listen to those podcasts because it's freaking incredible and Dana you truly are the epitome of ease within our company and for your clients and I just think you need to publicly shout it from the rooftops be Just recognized for that aspect of your personality. You truly do make life easier I know a lot of your clients feel the same way you are

so good at finding the easiest path for the systems implementation for whatever it is that needs to be done for us as a company. So Dana, welcome today. I'm so excited to have you here with me. Thank you for joining me on this beautiful Wednesday. I don't know what day this is gonna air, but it's a Wednesday today. And it's absolutely gorgeous here in Arizona. How are you, Dana?

Dana (01:08.193)

doing good, Tim, doing good. love days like today.

The Dental A Team (01:11.629)

I do too, I do too. It's starting to get fallish in Arizona, which means 85 degrees instead of the 105 that we had last week, least up in Phoenix. I know you get a little bit more fall down where you're at, but I'll take the 85 over the 105 for sure. Today, Dina, I wanted to pick your brain.

I've got some information today I wanna share with the doctors. It's also for billing departments, for treatment coordinators, for whomever wants to listen to this. But I really wanted us to shout out our doctors for really, really just knowing everything about their businesses. I know that you guys are all here listening. I know you're watching, whatever it might be, to really learn more about the business side and about what the team is doing to help support your practice. So I wanna shout you out for that. And I just think it's a really incredible tool.

and resource to have to truly know what it is that's going on, the inner workings behind the scenes of your practice, aside from just the dentistry that you're performing. So shout out to you guys for being here, for listening. Team members, if your doctor's not listening yet, please share it with them. Dana, today I really wanted to pick your brain and go over some coding information. I know it sounds super boring, you guys, but stick with us. We've got some great tips and tricks and some tools, especially for you doctors who are out there to really

focus in and pay attention to the things that are being input into the system and sent off to insurance companies, or if you're fee for service, you still need to be insanely accurate within your system and making sure that we're using the right tools. So doctors, again, this one's for you as well. Billing representatives, treatment coordinators, front office representatives, office managers, whoever you might be, whoever might be touching a ledger or an account or a code in general dental assistance, hi, Genes, you guys.

This is all gonna be really great information for all of you. Coding with Accuracy happens to be a book, by the way, you can purchase that. But honestly, coding with accuracy is incredibly important and valuable to your system, not only for the billing portion to ensure that we're accurately sending things off to insurance companies, accurately getting paid, but realistically to show super accurately what you've actually done with your patients to your patients. That way, if anything were to ever come about and anyone needed to look into it or

The Dental A Team (03:28.327)

your patients had questions and they asked for the account, it makes sense to the next person who's looking at it. And you can say, yes, I did that, that was me. I did that filling, I did that crown, I did that crown seat, I did those pieces. I know a lot of practices, and Dana, I think you've probably seen this too, a lot of practices will overuse, in my opinion, an office visit or a palliative treatment, to certain codes like that and unspecified, because they're just not sure.

what to use. And so they throw one of those, especially office visits, and I'm like, what is this office visit? How many, this patient's been in for 20 office visits. They're like, most of those are crown seats or like if a filling needed to be adjusted or like, and I'm like, wow, so we don't have any documentation right here that we ever sat any of these crowns.

That's an issue. looking at those pieces and making sure that we're super accurate with what we're calling things is something I really, really want to talk about today, Dana. Have you noticed that as well? I know you see a lot of clients, you do a lot of virtual clients, but you see a lot of ledgers, you get a lot of things sent to you, and you have been traveling a ton this year in office to practices as well. So what are you seeing when you're out there when it comes to coding and just kind of like randomness that you're seeing thrown around?

Dana (04:40.983)

Yeah, I agree with you on just like the miscellaneous codes. I delivery. What did we deliver? Because we need to know exactly what we delivered today. And then a lot of just like 999 things and sometimes a 999 code you absolutely

The Dental A Team (04:47.133)

Yeah.

Dana (04:55.967)

can utilize it, should be utilizing it, but oftentimes too, it's like, no, there's actually a code for that. Like we don't have to send a 999 with documentation and notes, there's a code specific for that. So making sure that offices really are up to date, also to like when things change because they do change occasionally. And so just having somebody who knows those things in and out has resources to spot check and that we are billing what we're doing and coding exactly what we're doing.

The Dental A Team (05:25.511)

Yeah, I totally agree. The 999 code, I love that one. It is thrown in there for everything and I am guilty of the 999 code because I'm like, don't know what he's even talking about. 999, that sucker. And I'll explain, I'll say exactly what he just said to me. I have no idea what he said, but I've got this. So I'm surely, surely guilty of that one. I do love the staying up to date and doctors, I really want you to know and understand within dentistry.

There's not, like we have a course for billing that will review billing for you and will go over the basics of billing, what it needs to look like, how to send a claim, how to input an EOB and a payment and all of those pieces. But there's really not a good school for billing where it's like, gosh, I'm gonna send them to a billing school and now they've got this accredited school has shown them this kind of like medical billing, right? You can go to medical billing school and now you're a medical biller.

to be a dental biller, you just needed someone ahead of you to show you how to do it. So within this world, it's just super important, like Dana said, that we stay on top of it as best we can. So making sure that we're getting ADA emails sent to us and that we're watching for any codes that change, because they will let us know. Whatever your state's dental association is, I know here it's the AZDA, the California Dental Association.

Whatever it is, make sure that you're signed up for those auto emails, because that's going to be the best resource. And then as those yearly conventions come around that we all love to go to, that we hate taking boring classes, look for any updates. I wouldn't say you've got to hit the billing courses yourself, or you have to send your billing rep to the billing courses. Sometimes they're a bust. Sometimes they're super insurance prone or driven. I don't love that. But if there's anything that's like coding updates or

New laws things like that. It's always a good idea. So I do want to preface it with that Just know always staying up to date just getting those resources sent to you is going to be super super important And now aside from that there are things like coding with confidence coding with accuracy All of those different books that you can get I believe coding with confidence you can order from Amazon or ADA I think both of them have it. I think it probably comes from the ADA when you do it from Amazon, whatever you choose

The Dental A Team (07:37.7)

It's a fantastic book and having that resource, there's a companion book that goes with it as well. I always had that resource with me. It was literally in a drawer behind my desk and as soon as I had something pop up for an implant or gosh, when we were doing over dentures and there's just so many parts and pieces and little things that need to be accurately coded.

There's no way I'm gonna remember all of these things or intuitively know it. So I would pull those books out constantly and I would go through it with my doctor and I'd say, okay, does this describe, is this what you're saying? Is this describing it? Because even just for regular dentures, there's different codes that can be used. And if you use one that's a maxillary but you're doing a mandibular denture, you're not gonna get paid, right? And even if you put upper denture in the thing and you did a mandibular code, they're still not gonna pay it because it doesn't match.

So just making sure that those codes are super accurate. Now from a doctor's standpoint, why is this important? Super important because you need to be paid, right? So my owner doctors, you need to be sure that your practice is being paid, that you're being paid for what you're doing, your hygiene team's being paid for what they're doing, and that if, again, anything were ever to have been and come about, somebody looking at the ledger, looking at the account, looking at the chart, can accurately and confidently see exactly what you performed. So not only do you need to get paid,

you need to cover your tail. For my associate doctors and even my hygienist who might be listening, you really, really wanna watch your production and your collections, because typically, especially my associates, you guys are gonna be paid off of that in some form or fashion. So making sure that the coding is correct and that it accurately, actually reflects what you've done is key. Otherwise, you might get paid for a filling when you did an onlay.

Right, and the billing representative, has, or he has no idea, they were not chair side with you. So if it's not fixed chair side, or if you, gosh, Dina, how many times have you seen this one, where chair side, you know, we were scheduled for an MO, chair side, doctor's like, this went into the distal, we've gotta update that. So we update it, we tell the patient, we're like, got another service added, get the treatment plan going, lay them back, finish the filling, and then they go up front, and then they get paid on an MO.

The Dental A Team (09:51.99)

because the MOD was never switched out and the appointment went before it was set complete. again, the billing representative, he's not chair side. They have no idea that that billing changed. The dental assistant needed to update and change it. So making sure that that's accurate in there. Now, Dina, I know you have a lot of practices and a lot of associates. You've got a lot of big practices that have a lot of associates. How do you make sure at the end of the day, at the end of the month, at the end of everything, that these guys are knowing exactly what their

being paid on? Like how do you make sure that they know with confidence that they're getting paid for everything that they did?

Dana (10:28.329)

Yeah, I have them usually daily check their provider production and check their individual provider day sheet just to make sure that everything was accounted for. If there were changes, if something was walked out inaccurately, catching that from the very beginning is super important because honestly, like you pointed out, the difference in some of these codes is hundreds of dollars worth of production. And that can be even within implant parts, even with indentures, like a difference in that

that coding can majorly impact production. So making sure that everything is accounted for, everything that they did is on there and everything is walked out and ready to submit. So that whether it's insurance based or we've got to call a patient and say, hey, you know, we under collected that service did change, we had added. whether it is patient portion that we've got to update or insurance portion, just making sure that we're catching that. And I like to do it daily because

Claims are submitted daily. We're reaching out to patients and we don't want a patient to go till the end of the month before we're like, hey, by the way, you missed a thing, right? So I like my, especially my associates and hygiene to just look and make sure everything's accounted for each and every day.

The Dental A Team (11:34.98)

Yeah. Yes.

The Dental A Team (11:47.01)

Yeah, I agree. think that's perfect because pulling that sheet, especially like Dentrix and Eagle Soft and OpenDone, like all of these programs have a super easy sheet to print at the end of the day or even like print screen and then just look at it. So we're not using all the paper all the time. I've definitely had it where a doctor will come back like a week later and be like, we didn't actually do a buildup because we just, you you treat and plan a crown and we should plan a buildup just in case, or you have your doctors who treat and plan only a crown and then add a buildup.

if we needed a buildup and so vice versa. A week later, we're like, I didn't build up on that crown. I'm like, well, bro, she gone, she lost. There's no way, it's so uncomfortable to call a patient and be like, by the way, we forgot to charge you for that billing that's underneath the crown that's to build the tooth back up because of the K. And now I'm in this whole conversation of like, why didn't this just get done the first time? So I totally agree. I think that's brilliant. And doctors also, looking ahead at your schedule,

Dana (12:21.687)

It was true.

The Dental A Team (12:43.172)

Prepping your schedule in conjunction with that is gonna be huge. We get really comfortable. Our dental assistants are incredible. I was a dental assistant near and dear to my heart. It's my favorite position. If I were ever to like quit everything in life and go back to in-office dentistry, it would have to be as a dental assistant. I would not do anything else. It's my favorite space. But you guys, I messed up sometimes. Like it happens. I would get forgetful.

Like how many times did I forget to grab the bond? And I'm like, you can't do a filling without a bond. How did you forget that? And then expecting me to change it every single time in the chart or make sure that it was accurate ahead of time. Things flip through the cracks. So we've gotta have checks and balances. We can't just rely on one person to get it right every single time. So your dental assistants prepping the charts, prepping your schedule for the next day is huge, but I really wanna implore that you guys, you doctors,

You are looking at your schedules as well. You know what's coming up and you know that it's accurate. I had a dentist that worked in our practice. He's fantastic. He's gone to all of this oral surgery, like extracurricular. He's just, it's insane. I watch his videos on Instagram and I'm like, that's so gross. I always must do him. Like I remember the first time I did a bone flap with you and I was like, what? I can't do this, but he's so good. He did all of these like perio surgeries, oral surgeries. He did so many things in our practice and holy cow.

A GP girl over here, learning how to code for all of these extensive procedures that he was doing. He was doing, you know, he's doing the blood draws before it was even a thing. I am like, are we allowed to do that? Like I'm in my practice, like what the heck? This is crazy. And now I'm having to code things that to me are like outlandish.

and I'm sitting there Googling things. Like, this doesn't make sense. So I'm pulling out my little code book and like, gosh, it is in here. This is a dental thing. We can do this, but there's no way those added procedures would have been accurately coded if I didn't take those extra steps to ensure it. And if he didn't, bless his heart, come to me every day.

The Dental A Team (14:47.322)

with a list of the things that needed to be added to tomorrow that wasn't accurate or things that we missed today. He would double check his treatment plans just because they were so extensive. And honestly, there were times, like he did GP work in our practice as well. So there were times too where he would catch a filling surface was missed or an onlay surface was missed. And I'm like, dang, not only are, you know, did we miss something on your giant surgery over here that I literally cannot assist with, cause I will pass out.

But we also miss like a surface on an online, like, goodness gracious, right? But he is my example because he was so diligent about making sure that the charting was accurate. Like, of course he wanted to get paid for the things he was doing, but he's like, I need to make sure that whatever it is that I'm doing, it's all here. It's all accounted for. And when he went to go do all of the accrediting with the oral surgery boards and implant boards and like, he's got all this crazy stuff behind him now. He needed all of those things. He called me from Texas years later.

And I was like, remember that patient that we did that thing? And I'm like, my gosh, yeah. So I'm like looking for this patient. He's like, I need all of their notes and I need all of their ledger and I need everything to submit to the implant board. And I was like, my gosh, thank goodness we went through and did all of those things. So you guys, it doesn't matter what you're doing. You don't have to be doing crazy dentistry or crazy oral surgery within your practice. Those minor things need to get caught as well. And Dana, earlier you mentioned like the 999 code.

And I know we have to go in or have the auto updates done and make sure that the codes are being updated. But I did notice there are more and more systems that even have as simple as broken appointment code already in there, Crown Seat Code, Denture Seat Code, all of these pieces. So when you're working with practices and you're seeing this, or they ask us, we'll get text messages from office managers that are like, this is what he said, what do I code that as?

I don't know, right? But what are you doing? How are you helping them to figure out, this is probably not a pallet over 999 or what an office visit, this is probably X, Y, or Z.

Dana (16:52.117)

Yeah, I mean, I'll be honest, if a lot of times I am pulling like a coding with confidence, or I'm googling things and, I'm trying to piece it together or I'm asking, you know, okay, well, like, walk with what does that look like? Walk me through like, can you explain the process to me? So maybe I can find it in here or send me a picture of the part that maybe I can look it up. But it's really just doing due diligence and combing through the codes that are available. And then determining

The Dental A Team (16:58.797)

Yeah.

The Dental A Team (17:10.987)

Yes.

Dana (17:20.083)

If there is a specific code for that procedure and if there's not, then yeah, you do a 999 code with lots of documentation, IOPs, all the things, so that once it gets to insurance, they can determine if it's something that they're covering.

The Dental A Team (17:35.266)

I agree, yeah, I love that. I do love Google, I have Googled so many times. I've been in office trying to help them come up with cheat sheets, which is the next little topic here, but that I'm like, what is this? Or give me a picture of this so that I can put it on their cheat sheet. And doctors who are doing things like implants or dentures even, crowns, anything you're doing, having those cheat sheets is super helpful.

I have a lot of my practices throw those into their operations manual. So with the crown setup or whatever, it'll also have the steps and the codes that would be used. We have to update it when they update, but have all of those available there side by side with it. So it'll be like, crown seed, and it'll be the setup, and then it'll be all of the codes. The ones that get wild are our implants, right? Our All-On-X denture cases. Those ones get wildly insane.

dentures, right, start to finish because what happens is in the treatment planning mode, let's use denture, right, as a treatment planner, right, so I'm a dental assistant and the doctor says we need to do a full denture. Cool, maxillary denture. And then I'm like, treatment coordinator, here you go. And they're like, cool. And then they schedule a denture. There's like 16 steps sometimes to a denture.

Right, so having that and being able to break it down and break it apart shows that all the steps and processes were done and then having a cheat sheet that goes along with it helps not only your treatment coordinator and your scheduler, but it helps your biller and your dental assistant, even your hygienist. I've had so many hygienists come to me and say, what step are we on? And I'm like, well, I'm not sure, let's look. Like, let's look at our checklist and see where we're at. So even within that denture, having the denture treatment plan for pricing.

Dana (18:56.011)

Yes.

The Dental A Team (19:24.294)

Obviously, right, any extractions, any bone grafts that need to be done. If you're doing a temporary denture before the final is done, if you're doing, gosh, if you're doing a scan and a final delivery, like they're getting much faster. But before, remember, we had to have a wax rim, we had to have teeth and wax, we had to have the color shade, we had to have a try-in, then we had to have a realign. Like all of these pieces needed to be segregated out in there so that we treatment plan.

the one thing, but we have those steps readily available so that it can be scheduled correctly and in order. And then having those cheat sheets with those codes lined up is super helpful. I have a practice in Wisconsin that was just getting so confused on the implant process and an ortho process. And I was like, easy peasy, let's just like section this out. And now every single time they've got it laminated and they just pull it out. They're like, I've got my implant sheet. I've got my ortho sheet or whatever. So I always have them add that as well. So Dana.

Wrap it up for us. So we've got coding, checking, all the pieces. What could an office do, a doctor do to ensure maybe even adding it to their operations manual? What's the process they should make sure that is being followed and updated yearly within all of these pieces that we've talked about today?

Dana (20:42.627)

Yeah, I think it's added to your yearly calendars that you make sure that you do know the updates you have the codes every year and just like we get Insurance fee schedules and we do all of our insurance updates just add that to that list one So add and make sure we've got do we have the resource for it? And do we know what they are? I think to any time that you are adding a new service just checking and double-checking that you know what the codes are So if you're bringing in a CBC team, make sure that those codes are in there and you've got fees attached to them

and all of those pieces. I love your cheat sheet idea as far as especially where there's a there's a lot of nitty-gritty things that need to get built out for specific things like ortho-like implants making sure that you've got cheat sheets and you make it really really easy and then make sure you've got a very clear communication system for when treatment changes so that it gets changed all the way okay and then I think daily having people look at them and just one

Final tip I guess in in with your cheat sheets oftentimes we call things things that like are not in the code, right? The description of the code is not that and then we're constantly like, what are they actually? What do they actually call right? A lot of your systems will allow you to add notes to like those procedure codes put in what you call it in the office so that it's easy to find it will still put the actual code definition on your piece going on your claims go out, but if you call something something specific

just update it in your system so it's easy for the team to buy.

The Dental A Team (22:12.623)

That was brilliant. I know my dentist had like five different terms for a hater bar and I never, was like, I don't know what you're talking about. And the Ribon, he would call the, you know, the Perio procedure by the name of the material he needed. And I was like, so, and he only do this once every, I don't know, 10 years. Like this procedure is never done. He's like, we've got to do a Ribon. Where's the Ribon? I'm like, I don't even remember what this is.

I don't know what that says. So yes, I agree. I love that idea, the descriptions and making sure too then I would transfer. We do this in our Google Drive, you guys. Whatever you might call it, also probably put that on your cheat sheet, maybe in parentheses. Like this is what it is. These are the five different terms that any of our doctors may call it so that it is easy to find and easy to figure out. I think that's brilliant. Awesome, thank you for wrapping us, Dana. I think this was insanely beneficial for all of our doctors out there and our team members again.

Doctors, if you're here listening, congrats. I think that's so huge. It's really important for you to know and understand these things. Share it with your team, because they can use these pieces too, especially anyone who's doing your billing and your practice. And then team members who are out there whose doctors haven't heard this one yet, share it with them. Make sure that they understand what they're getting into as well, and that they're supporting you in your position as a team member to be super accurate, because you're depending on them.

to get things right so that you can do your job. So share it with them. Make sure you guys are all up to date and as always, reach out for any questions you might have. [e-mail]. We are not code masters, but you guys, we are solution masters and we will find the answers or find the way and we can help you with just about anything you can think of. [e-mail]. We can't wait to catch you next time.