Fast Facts: Coding Episode 9
[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 this edition of your Coding Fast Facts. My name is Teresa Duncan with Odyssey Management. Today we're going to talk about D0171, which is a follow up code. It's a post op evaluation code that is so criminally underutilized. I like to say that about this code, it's criminally underutilized. Same thing with adult fluoride. One of those codes that just is there, and I just think it could be used more. When I run evaluations of practices and take a look at their procedure, service mix, D0171 often isn't even on the list of top 20 or 30 codes. And I want to see if there's room in your practice to include it in your workflow.
So, first of all, this is, of course, an evaluation. And what that means is it's going to be subject to the two per calendar year or the one every six month limitation. Most plans have limitations on evaluations, and those are the two most common ones. Now, the most practical example of using D0171 is after scaling and root planing or after any kind of osseous surgery, many people are using the D0180, it's basically a periodontal evaluation. It's more of a periodontal comprehensive evaluation. They're using one 0180. But 0180 is a very heavy code, meaning that you have to do a complete comprehensive evaluation, and then you have signs, symptoms of periodontal disease and you're educating on that and you're doing assessments for periodontal disease. So if you're doing a complete head and neck exam, you're doing a screening for oral cancer, you're calling out existing conditions. That's a periodontal evaluation. I don't think you're doing that post scaling and root planing. I'm guessing that you're really doing a D0171, which is an evaluation post op. So after a procedure post op.
Another example of this is, should you need to see a patient after a really crazy extraction, you're worried about that site, you want to double check it. That appointment coming back in is not a looksi appointment. It's not a D0140, which is your limited evaluation. That actually is a proper D0171. So I urge you to take a look at this code and really see if you can apply it to a lot of places or a lot of workflows in your office. I suspect that you can. Typically when I start asking the doctors and their teams, when do you see patients for a follow up? When do you see patients back just to check to see if everything is okay and all those situations 0171 is most likely the billable code, the most appropriate code that you can use in that particular predicament. So go in and take a look at your workflows and see if perhaps you're missing out on using this code. Pricing wise typically, it's going to be anywhere from between your limited evaluation to your comprehensive evaluation. That's typically where I set it. I know a lot of offices will just price it the same as their limited evaluation. Carrier wise they're going to again apply the benefit limitations such as two per year or one every six months. I just think that this is a good code to use. I loved it when it came out. I cheered when it came out, because there is just no other way to bill accurately for just a quick look in there, right?
Oh, let me go back to the scaling and root planing. So in the post op evaluation, you're doing a lot of things, but you're not necessarily doing a comprehensive evaluation. And that's why this code is more like it. You're basically following up to a procedure, you're going to come up with, along with your doctor, come up with a plan of attack for patient treatment based on that procedure. Okay? So that's really why that code is a more accurate and more appropriate code. Now, again, as it goes with if you listen to the last coding Fast Facts we talked about evaluations, and you will remember that evaluation codes are typically only going to be billable by the provider, the DDS, the license holder of the DDS. And unless you're in a state that allows you to practice independently, it's most likely going to be billable under the dentist. Now, that doesn't mean that you may not get the credit for it collections wise. So you're going to have to talk about that with your office and take a look at your contract. But I'm going to ask you to go back to your office, take a look at 0171 and see if you can fit it into your workflows. I think it's going to be a very handy code. I hear from people all the time that once they start using it, they identify all sorts of other scenarios that they should have been using it in, and they're excited to have it. So I hope that that is the case with you until the next edition of Coding Fast Facts. I want to thank you very much for listening to me. You can find me at www.Odysseymgmt.com. Thank you so much.
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 www.dentistrx.com. We'll see you next week for another Fast Fact!