The Do’s and Do Not’s of Diagnostic Billing

March 4, 2019

A common question we receive as a dental medical billing department is whether the provider can bill out diagnostic services in addition to the surgical or medical services they are providing. The answer is a resounding YES!!! Providers can and should bill out any diagnostic procedures. Here we will walk you through the Do’s and Do Not’s of diagnostic billing.
DON’T do your diagnostic procedures on the same days as your surgical procedures or sleep apnea appliances. Almost all carriers will bundle these services as “inclusive” of the other, more expensive, services and severely reduce your reimbursement.
DO have a consultation/pre-operative appointment with the patient. Bill out any x-rays you do at the time of that visit, intraoral pictures, diagnostic casts and other services.
DON’T skimp on the clinical notes because it is an exam or office visit. Make sure you are documenting what procedures you are consulting with the patient about, their symptoms, their medical history, their blood pressure and any possible complications.
Billing out diagnostic procedures can also be helpful to your patient. These are procedures that can be filed to their medical carrier to help them meet their deductible and out of pocket maximums but then filed as a secondary to their dental insurance. This overall will lower their out of pocket patient cost and helps them to afford more treatment than they may have envisioned. Patients are more likely to schedule and return to providers that seem thoughtful about the sensitivity of finances.