5.5 Simple Steps to Jumpstart Diagnostic Coding

Presented by: Christine Taxin

Original Presentation Date: September 15, 2015

Course Description:

"5.5 Simple Steps to Jumpstart Diagnostic Coding" is a workshop designed to empower dental teams with the essential knowledge and practical skills to navigate medical/dental cross-coding and maximize reimbursement through medical insurance. This comprehensive course offers a step-by-step approach to claim processing, encompassing patient interaction, code understanding (diagnostic, procedure, and DME), modifier application, CMS-1500 Form completion, and requisite documentation. Participants will grasp effective follow-up and appeals strategies, clarifying common pitfalls that lead to claim denials. The curriculum dives into interpreting various insurance plans, recognizing billable procedures, comprehending the authorization process, emphasizing the significance of S.O.A.P. documentation, and obtaining patient benefit information. Moreover, attendees will learn to leverage diagnostic tools, interpret medical necessity information, report biopsies and oral lesions, and prioritize/report medical diagnostic and procedure codes. Additionally, the course provides insights into the history, structure, and format of the ICD-10 coding system, equipping dental practitioners with a holistic understanding of diagnostic coding principles and practices.

Learning Objectives:

• Recall the primary benefits of medical/dental cross-coding and the pivotal role of understanding medical insurance for successful reimbursement.
• Grasp the complexities of medical billing, gain insight into the diagnostic, procedure, and DME codes, modifier usage, CMS-1500 Form completion, and essential documentation requirements.
• Implement a systematic approach for claim processing, from initial patient interaction to final payment, demonstrating proficiency in follow-ups, appeals, and strategies to prevent claim denials.
• Assess different insurance plans, categorize billable procedures, comprehend the authorization process, and evaluate the importance of S.O.A.P. documentation for effective billing.
• Judge the efficacy of working with insurance companies to obtain patient benefit information and utilize diagnostic tools while discerning the significance of reporting medical necessity information, biopsies, oral lesions, and prioritizing/writing diagnostic and procedure codes.
• Generate a comprehensive understanding of the ICD-10 coding system, fostering the ability to interpret, apply, and navigate diagnostic coding principles within a dental practice setting to optimize reimbursement.

Speaker Bio:

Christine Taxin is the founder and president of Links2Success, a practice management consulting company in the dental and medical fields. Before starting her own consulting company, Ms. Taxin was a critical care department administrator at Mt. Sinai Hospital in New York City and managed an extensive multi-specialty dental practice in New York. With over 25 years of experience as a practice management professional, she now provides private practice consulting services, delivers continuing education seminars for dental and medical professionals, and is an adjunct professor at the New York University (NYU) Dental School and Resident Programs for Maimonides Hospital.