Coach's Corner for Dental Coding: Caries risk assessment codes

There is finally a code for caries risk assessments, which dental professionals have been doing for years with no code.

Aug 18th, 2014
Dentist Counseling

QUESTION: What has been your experience with the new caries risk assessment codes (D0601, D0602, and D0603)? What are offices doing with denied charges?

ANSWER: Many offices have been performing caries risk assessments for years but never had a code to use. Now we do. Unfortunately, the existence of a code does not mean that benefits are always available. Some offices have reported using these codes with a zero charge and not billing them to the insurance companies. In essence they’re using it as a tracking code rather than for billing purposes.

We have not heard of any consistent reimbursement for the codes listed above. They have been returned as non-billable and included in exam codes. If you are a PPO office, you will be asked to write off the amount. Non-participating offices can bill the patient.

READERS: Please let me know if you have received payment. I’d love to be able to update my audiences and readers. Thank you!

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Teresa Duncan, MS, FADIA, FAADOM, is an international speaker who addresses topics such as insurance coding, office manager training, and revenue growth. Her company, Odyssey Management, Inc., provides virtual, customized training in these areas. She can be reached at Teresa@OdysseyMgmt.com. Inquire today about Odyssey’s Billing & Coding ESupport program!

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