While many NMD practices do not have much to do with insurance (except to assist patients in filing their own claims), if you treat pain/dysfunction patients, what insurance coverage there may be will probably be in a patient's medical coverage - not in their dental plan. If you have not treated TMD patients before, the differences in medical insurance may be new to you. While diagnostic codes (ICD codes) are reasonably specific, because the coding of medical insurance is essentially controlled by medical doctors, it is sometimes challenging to find a proper code for a procedure (CPT code) done by a dentist. You must choose a code that most closely resembles the service you have provided. You may alter the verbal description for a given code - in fact if the code description does not precisely match your service, it is often best to alter the description to truly reflect what you have done. In that way, no one can accuse you of being deceptive.

Virtually all states have laws prohibiting discrimination of coverage by professional degree. If what you are doing is lawful under your license, medical insurers should not deny coverage simply because you are a dentist.

Some of the basic coding information commonly used by NM practices is presented here. Should you desire more detailed information or professional assistance, it is available from Nierman Practice Management www.rosenierman.com or (800) 879-6468. Medical Insurance Codes

ICD Codes: These are diagnostic codes. Following are some of those commonly used in pain/dysfunction dental practices.

CPT Codes: Known as Level I codes, these are the procedural codes, used primarily to identify medical procedures and services provided by physicians and other health care professionals. As mentioned earlier, as written in the CPT coding manual, a number of them are not truly specific to some of the procedures used in the dental treatment of pain/dysfunction. Following is a list of procedural Codes used by many NMD practices.

HCPCS Codes: These codes, known as Level II codes, are used to describe products, supplies or services not included in the CPT codes (such as durable medical equipment).