Thursday Troubleshooter: What can frustrated dentist do about ADA coding system?
This dentist is frustrated with the coding system, and wonders what dentists’ legal and ethical obligations are when it comes to abiding by the ADA coding system?
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QUESTION: What are dentists’ legal and ethical obligations to abide by the ADA coding system? The only way to break free from the shackles of dental insurance and “procedural” dentistry would be to cease using the codes and descriptions and instead create a new system of care unrelated to the current codes. Is this legal and/or ethical? Are we as licensed dentists legally bound to use that system?
ANSWER FROM CHRIS SALIERNO, DDS, editor of Dental Economics:
If you are contracted with a third party payer, then you are legally and ethically bound to adhere to their coding system, which is the ADA's Code on Dental Procedures and Nomenclature (aka CDT Code). You may disagree with some of the terminology or how procedures are classified, and there is a process for reform! The ADA's Council on Dental Benefit Programs (CDBP) meets regularly to update the code. Speak with your local dental society about contacting your representative to the Council and have your voice heard.
However, I'm sensing that you’re looking for a larger reform. We've been reporting on large-scale efforts to change how dentists can be fairly compensated for their services and dental care can be made affordable. There is not a simple answer here.
But I would again advise you to take your ideas to your local dental society and have your voice heard. You can become more educated about these issues and bring more attention to your cause. I've been involved with organized dentistry since I was in dental school and I can tell you, it is greatly satisfying to turn a common frustration into actual legislation.
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