I am making an assumption, so please forgive me if it is
incorrect.
I would say that the Dental claim is not intended to be used
by Dentists alone. It is intended to be used for Dental
services.
From the IG. "This is the
implementation guide for the ANSI ASC X12N 837 Health Care Claims (837)
transaction for dental claims and/or encounters."
While
most dental services are performed by a dentist, there are many dental services
performed by other types of healthcare providers. The IG does not even
limit this to Dentists, it only refers to those as "providers".
From the
IG. "The implementation guide also specifies
limits and guidance to what a provider (submitter) can place in an
837."
Just an opinion and does not reflect a company
opinion.
Thanks - Kurt
(410)
668-1592
[EMAIL PROTECTED]
> -----Original
Message-----
> From: Tom Drinkard [mailto:[EMAIL PROTECTED]]
>
Sent: Saturday, March 15, 2003 11:17 AM
> To: WEDI SNIP Transactions
Workgroup List
> Subject: RE: 835D or P for Medicare dental
claims?
>
>
> While I agree with much of the response from
askshipaa, the
> following statement puzzles me:
>
> "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."
>
> Can anyone provide justification for the above? I
am unsure
> where to find any reference to this in the law or the
>
subsequent regulations.
>
> Tom Drinkard
> EDIT, Inc.
>
[EMAIL PROTECTED]
> (678) 795-1251 (voice)
> (775)
458-6117 (fax)
>
>
> -----Original Message-----
> From:
Kathy Brouch [mailto:[EMAIL PROTECTED]]
>
Sent: Thursday, March 13, 2003 11:36 PM
> To: WEDI SNIP Transactions
Workgroup List
> Subject: RE: 835D or P for Medicare dental
claims?
>
>
> 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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