Changes in Medical Billing for 2014: The New CMS1500 Claim form and ICD-10

Major changes are coming for dentists who are billing medical insurance for their patients: The mandatory changes include a new claim form to be used as of April 1, 2014, and a new diagnostic coding set on October 1, 2014.

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Rose Nierman, Founder and CEO of Nierman Practice Management

It’s important for dentists to be aware of the major changes on the horizon in medical billing in order to avoid lapses in reimbursements from health insurers.

Tequesta, FL (PRWEB) February 10, 2014

Nierman Practice Management is in the process of getting dentists ready for 2014 billing changes with their popular DentalWriter™ and CrossCode™ software systems. Many procedures performed in a dental office may be considered by medical insurers as “medically necessary”. Some treatments which may be covered by medical insurance include temporomandibular joint (TMJ) disorders, sleep apnea mouth guards and oral surgeries.

The changes include the new diagnostic coding set and new medical claim form, both scheduled to take place in 2014. These changes are required for anyone covered by HIPPA. According to Courtney Snow, Implementation and Training Manager for Nierman Practice Management, “It’s important for dentists to be aware of the major changes on the horizon in medical billing in order to avoid lapses in reimbursements from health insurers”. Snow helped to build a medical billing help center, Nierman’s on demand training center for DentalWriter users.

The biggest change on the new claim form is the inclusion of eight additional areas for healthcare providers to list diagnosis codes associated to the claim. The current version only allows four spaces per claim to list related diagnosis codes. Other fields have been removed or changed as well. For example, the new claim form will no longer ask for marital status, employment status or the insured’s employer/school name.

As far as the diagnostic codes are concerned, they are set to change to ICD-10 on October 1st, 2014. ICD-9 is the current diagnostic coding system in effect. The diagnostic coding system contains codes for identifying: diseases, signs & symptoms, abnormal findings, complaints and causes of injury/disease. “It is important for physicians, dentists and other healthcare providers to understand that ICD-10 is not simply the ICD-9 renumbered”, says Rose Nierman, CEO of Nierman Practice Management. “ICD-10 is a completely new coding set that is organized differently to allow for more flexibility and accurate diagnosis reporting”.

The ICD-10 coding set allows for over 14,000 different codes and expands to over 16,000 with use of optional sub-classifications. For example, ICD-10 codes allow 3 to 7 characters for a diagnosis code whereas the ICD-9 only allows 3 to 5 characters. These changes to the diagnostic coding system do not affect the CPT or HCPCS coding systems which identify procedures, professional services, equipment and supplies.                                                                                                                            

About Nierman Practice Management
Rose Nierman founded Nierman Practice Management in 1988 as a continuing education company, teaching dentists how to expand their practices with medically necessary services. Developed as a tool for implementing medically necessary procedures in a dental practice, CrossCode™ and DentalWriter™ software have revolutionized medical billing and documentation protocols. Nierman Practice Management has helped more dental practices collect medical reimbursement than any other organization.

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