Medical Billing Dilemma – Dental Pain Codes

Finding the correct pain code when you’re compiling your medical billing can be a tricky issue, especially when dealing with dental matters. The trick to billing these types of procedures correctly is to narrow down the chief complaint.

If a patient comes into the ED and presents a complaint of a dental wire sticking into their lip or tongue, you have a very clear chief complaint. If nothing was actually done to treat the issue but the patient was given advice such as checking with the dentist or getting supplies to relieve the pain from a local store, you can probably still get a reimbursement for the consultation services.

In this manner you would not use the coding for dental hardware pain since the hardware was not the issue, you would use the chief complaint of lip or mouth pain as the chief complain the reason the patient presented to the ED.

Dental issues cause a lot of confusion and many insurance companies carefully scrutinize any claim that has to do with dental issues. Simply document your claims to the hilt, double check your coding to be absolutely accurate and you should have no problems getting reimbursed for your claims.

View all Articles by: Melissa Clark, CCS-P