This is a response I received that may help with this question. 

Kathy Brouch, RHIA, CCS
Practice Manager
Coding Products and Services
American Health Information Management Association
233 N. Michigan Ave., Suite 2150
Chicago, IL  60601
Telephone: (312) 233-1520
Fax: (217) 525-2899
e-mail: [EMAIL PROTECTED]

-----Original Message-----
From: AskHIPAA AskHIPAA [mailto:[EMAIL PROTECTED]
Sent: Wednesday, September 18, 2002 8:51 AM
To: [EMAIL PROTECTED]
Subject: Re: Code on Dental Procedures


Kathy - "Dental" services are a subset of "health care."  A dentist is a
"health care provider" - on of the three types of "covered entities" under
he law.  We do not have a regulatory definition of "dental services" just as
we don't have one for "physicians' services," etc.

If someone other than a dentist performs dental services and wants to send a
claim to a health plan, that person would use the 837 Dental Claim.  There's
no HIPAA requirement that the provider who submits an 837 Dental be a
dentist, but a health plan may have such a requirement.

The Code on Dental Procedures is the code set to be used on the 837 Dental
Claim.  If a dentist performs jaw surgery or some other procedure for which
no Dental Procedure code exists, the dentist or other practitioner would use
a CPT code and submit an 837 Professional Claim, not a Dental Claim.  

I hope that this answers your questions.


>>> Kathy Brouch <[EMAIL PROTECTED]> 08/07/02 03:42PM >>>
According to the final rule, the Code on Dental Procedures and Nomenclature
is the standard medical code set for dental services.

What is the definition of dental services?
Does this standard apply only to dentists? 
Is this code set only to be used on ASC X12N 837, Health Care Claim Dental


Kathy Brouch, RHIA, CCS
Practice Manager
Coding Products and Services
AHIMA
233 N. Michigan, Suite 2150
Chicago, IL  60601
E-mail: [EMAIL PROTECTED] 
Phone: (312) 233-1170
Fax: (312) 233-1470

Be sure to visit "Communities of Practice" -- AHIMA's newest member benefit!
See www.ahima.org.


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