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The 2012 edition of the Dental Claim Form includes fields for diagnosis codes and instructions covering the use of the ICD-9-CM and ICD-10-CM coding systems. In addition to ICD-9-CM and ICD-10-CM there are other dental diagnostic coding systems under consideration, including SNODENT and EZCODES. [7]
List of ICD-9 codes 140–239: neoplasms; List of ICD-9 codes 240–279: endocrine, nutritional and metabolic diseases, and immunity disorders; List of ICD-9 codes 280–289: diseases of the blood and blood-forming organs; List of ICD-9 codes 290–319: mental disorders; List of ICD-9 codes 320–389: diseases of the nervous system and sense organs
The Major Diagnostic Categories (MDC) are formed by dividing all possible principal diagnoses (from ICD-9-CM) into 25 mutually exclusive diagnosis areas. MDC codes, like diagnosis-related group (DRG) codes, are primarily a claims and administrative data element unique to the United States medical care reimbursement system. DRG codes also are ...
In health care, diagnosis codes are used as a tool to group and identify diseases, disorders, symptoms, poisonings, adverse effects of drugs and chemicals, injuries and other reasons for patient encounters. Diagnostic coding is the translation of written descriptions of diseases, illnesses and injuries into codes from a particular classification.
Dental insurance companies divide benefits, services, or procedures into categories and refer to them with American Dental Association (ADA) 3-4 digit code. As an example, Preventive and Diagnostic procedures often include exams (ADA code 0120), x-rays (ADA code 0210), and basic cleanings or prophylaxis (ADA code 1110).
Procedure codes are a sub-type of medical classification used to identify specific surgical, medical, or diagnostic interventions. The structure of the codes will depend on the classification; for example some use a numerical system, others alphanumeric.
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The amount that is paid by the insurance is known as an "allowed amount". [19] For example, although a psychiatrist may charge $80.00 for a medication management session, the insurance may only allow $50.00, and so a $30.00 reduction (known as a "provider write off" or "contractual adjustment") would be assessed.