Specialty billing
Dental billing services
Dental billing is coding each procedure with the ADA’s CDT codes and claiming it under the patient’s dental plan with the X-rays and narratives the plan asks for, or on a medical claim when a medical plan covers it.
Dental
Two claims, one patient
- Dental claimD0120D1110D4341CDT codes, updated each January
- Medical claimCPTICD-10Oral surgery, accidents, sleep apnea appliances
Try it
Dental claim or medical claim?
Most procedures go to the dental plan with CDT codes; some may go to the patient’s medical plan.
Dental claim or medical claim?
CDT · CPTPick a procedure.
The dental claim
- D0120
A CDT code on the dental claim. Plans limit how often they pay for it.
Why is dental billing hard?
CDT changes every year
Dental procedures are billed with the ADA’s CDT codes, such as D0120 for a periodic oral evaluation or D4341 for scaling and root planing, and the code set is updated each January.
Plans limit how often and how much
Dental plans pay within frequency limits (two cleanings a benefit year, for example), annual maximums, waiting periods and clauses such as missing-tooth exclusions, and every plan sets its own.
Downgrades and attachments
Many plans pay a tooth-colored filling on a back tooth at the amalgam rate, and crowns, periodontal treatment and some extractions need X-rays, charting or a narrative before they are paid.
Some procedures go to the medical plan
Oral surgery, treatment after an accident and some appliances, such as an oral appliance for sleep apnea, may be covered by the patient’s medical plan, billed on a medical claim with CPT or HCPCS and ICD-10 codes.
Two plans, one patient
A patient with two dental plans needs coordination of benefits, and the order the plans pay in decides what each one pays.
What Beeline handles for dental practices
- Eligibility verificationBenefits checked before the appointment: frequencies used, the maximum left, waiting periods and what the patient owes.
- Medical codingProcedures coded with the current CDT codes, and with CPT or HCPCS and ICD-10 codes where a medical plan covers the work.
- Claims submissionClaims sent to the right plan first, with the X-rays, charting and narratives each procedure needs.
- Denial managementDenials for frequency, missing attachments or downgrades traced to their cause, then corrected or appealed.
- A/R follow-upUnpaid dental claims followed up by plan and age until they are paid or closed.
Dental billing questions
What are CDT codes?
Can a dental practice bill a patient’s medical insurance?
What is a dental downgrade?
Find out where your dental billing stands.
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