With respect, I disagree. While it would be simpler for many if all "Dental" claims used the 837-D, that is not the case. As I understand it, HHS has licensed the Code on Dental Procedures and Nomenclature from the ADA and includes the entire code set in HCPCS. Consequently, the 837-P (and the 837-I, for that matter) fully supports all of the "ADA" procedure codes.
Here are some of the scenarios where an 837-D is more appropriate: . For predeterminations (aka pre-treatment estimates) . If missing teeth information must be reported. . If tooth codes, tooth surfaces or oral cavity areas must be reported. . If certain dates must be reported (Initial placement date, Appliance Placement Date, etc.) Here are some of the scenarios where an 837-P is more appropriate: . To report diagnosis codes . To report procedure code modifiers The above lists are certainly not exhaustive, but are intended to highlight some of the differences between the 837-D and the 837-P. Lack of support for the "ADA" codes is not one of the differences. Hope this helps. Tom Drinkard EDIT, Inc. [EMAIL PROTECTED] (678) 795-1251 (voice) (775) 458-6117 (fax) -----Original Message----- From: Fulton, Rick [mailto:[EMAIL PROTECTED] Sent: Thursday, March 13, 2003 1:14 PM To: WEDI SNIP Transactions Workgroup List Cc: Stanley Nachimson (E-mail) Subject: RE: 835D or P for Medicare dental claims? They need to use the 837 D (Dental) transaction -----Original Message----- From: Tucci-Kaufhold, Ruth A. [mailto:[EMAIL PROTECTED] Sent: Thursday, March 13, 2003 12:32 PM To: WEDI SNIP Transactions Workgroup List Cc: Stanley Nachimson (E-mail) Subject: RE: 835D or P for Medicare dental claims? I am concerned Medicare would not be compliant. How can Medicare state that they won't accept a HIPAA mandated transaction? Isn't Medicare a payer too? The ADA codes are not included in the 837-P(at least not in the Appendix C for the v4010 Imp Guide) ... so only those dental codes that are in HCPCS would be available for payment by Medicare? Could more detail be given on this subject? Ruth Tucci-Kaufhold HIPAA Systems Analyst Co-Founder MAHI UNISYS Corporation 4050 Innslake Drive Suite 202 Glen Allen, VA 23060 (804) 346-1138 (804) 935-1647 (fax) N246-1138 [EMAIL PROTECTED] -----Original Message----- From: Kathleen Simmons [mailto:[EMAIL PROTECTED] Sent: Thursday, March 13, 2003 6:27 AM To: WEDI SNIP Transactions Workgroup List Subject: RE: 835D or P for Medicare dental claims? That's correct. Medicare does not cover general dental care, but under our medical benefits, we do pay for treatment of injuries to the mouth area, some of which may be performed by a dentist. We will not accept the 837-D, only the 837-P. >>> "Tom Drinkard" <[EMAIL PROTECTED]> 03/12/03 06:11PM >>> >>> Diana, As I understand it, Medicare will not accept the 837D, since Medicare requires the diagnosis code. So, all Dental claims must be submitted on the 837P. Keep in mind that Medicare processes only 0.25 million Dental claims per year. That really isn't very many claims by Medicare standards. Since Medicare doesn't really cover Dental procedures, I suspect that the majority of the claims are those things that cross over between Dental and Medical such as high-end Oral Surgery procedures. Hopefully someone from CMS will chip in and confirm the above. Tom Drinkard EDIT, Inc. [EMAIL PROTECTED] (678) 795-1251 (voice) (775) 458-6117 (fax) -----Original Message----- From: Diana Lindsley [mailto:[EMAIL PROTECTED] Sent: Wednesday, March 12, 2003 5:04 PM To: WEDI SNIP Transactions Workgroup List Subject: 835D or P for Medicare dental claims? We have heard several different requirements, but have not gotten a definitive response. Hopefully, someone on this list will know. We have heard that Medicare will require the 837P transaction for dental claims, which doesn't make much sense to us. We have also heard that the 837D can be used. Does anyone know which will be required? Diana Lindsley Project Manager First Pacific Corp. --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-transactions as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
