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Fast Facts: Coding Edition - D9993

Fast Facts

Fast Facts: Coding Episode 7

[Andrew Johnston, RDH]
Welcome back everyone! You are listening to another episode of Fast Facts- Coding Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Teresa Duncan, MS.
[Teresa Duncan, MS]
Hello and welcome to another edition of your coding Fast Facts. Today we're going to talk about D9993, which is dental case management, motivational interviewing. This might be a new code to you. This is not very often used and it is just one of those that sits down at the bottom of the code set, and unless you're going and looking for it, you may not even be aware that it's been there for quite a few years! There's a whole suite of dental case management codes, so if you'd like to wander down into that subset of codes, you might find a couple more that could be applicable. But let's talk about motivational interviewing for today. Let's discuss the actual descriptor of it. It's patient centered, personalized counseling using methods such as motivational interviewing to identify and modify behaviors interfering with positive oral health outcomes. This is separate from traditional nutritional or tobacco counseling. An added note here is that there are codes for nutritional and tobacco counseling. They're up in the preventive section. Unfortunately, you don't find a lot of reimbursement for these unless it is a public health system like maybe the VA or Indian health services or some Medicaid plans. It's not very different for this particular code and indeed all of the other dental case management codes. So if you are a Medicaid office, then you probably are able to get reimbursement for this. And so make sure that you are incorporating this into your procedures if it's applicable, if your patient could be helped by it.
What is motivational interviewing? Basically, it's moving the patient along their continuum of accepting the fact that their oral health needs help, that you can help them, that there's treatment that needs to be accepted. There's a lot of information out there. I urge you to check out books that are actually focused on this. If you do a search for motivational interviewing in healthcare and even motivational interviewing in dentistry, you'll find a lot of resources. If you're going into the public health sector or if you're planning on working in a pediatric setting for the rest of your hygiene career, this is something that you're definitely going to want to look into because this is what they are doing in those particular settings. Before I get into how that can then be helpful to your practice, just real quick, if it is a traditional health insurance plan, dental insurance plan, you're not going to see much reimbursement on this and in fact, some of the more restrictive plans will actually tell you that you can't even collect from the patient on this. So again, these patient management codes are definitely more seen in the pediatric setting, in the Medicaid setting, and in the VA setting.
So let's go back here to why we would be using this particular code in the practice. Well, there are many settings where there is distrust of dentists, of hygienists, of what we do in healthcare. There is a general feeling that they don't need the work that they need. Now, if I'm saying this and you're thinking, well, that's most patients well, that's true, but there are definitely populations that are documented to have a harder time with accepting treatment or complying with treatment and that's really what these case management codes are aimed for. So keep that in mind. But I highly urge you to go find some books on motivational interviewing in healthcare and in dentistry. I have read some excerpts from several of those books over the years, and I find it very fascinating and it has also been very helpful in my own conversations with patients when I'm talking just about treatment plan, case acceptance, all of these tips that I picked up from those books have indeed been very helpful. I hope these tips have been helpful, and until the next one, thank you so much for tuning in!
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts -  Coding Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at We'll see you next week for another Fast Fact!

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