Eligibility & Verification
Coverage checks before every visit.
Specialty Billing
Dental Billing Medical Billing
Dental billing increasingly crosses into medical claims for procedures like surgery, trauma, and sleep appliances. We manage CDT and CPT coding and pre-determinations so dental-medical crossover claims are paid.
The Challenge
Dental Billing billing, solved
We understand the billing complexities unique to dental billing and build them into every claim.
- Dental-to-medical crossover claims
- CDT vs. CPT coding
- Pre-determinations and approvals
What we focus on
- CDT procedure coding
- Medical crossover billing
- Pre-authorization handling
Coding Focus
Dental Billing code sets we work in
The CPT/HCPCS procedure families and ICD-10 diagnosis groups our certified coders handle for this specialty every day.
Common CPT / procedure codes
- D0120–D0180Periodic and comprehensive oral evaluations
- D2740–D2799Crown restorations and related prosthetics
- D7140–D7250Routine and surgical tooth extractions
- D4341–D4346Scaling and root planing periodontal therapy
ICD-10 diagnosis focus
- Caries, pulpal, and periodontal disease (K00–K14)
- Dentofacial anomalies and temporomandibular disorders (M26 family)
- Facial and dental trauma or fractures (S02–S03)
- Sleep-related breathing conditions for appliance therapy (G47.33)
Code references are shown as general identifiers for illustration. Actual code selection always follows current payer rules and your provider's documentation.
Clean Claims
Modifiers, denials & billing rules we manage
How our team keeps dental billing claims compliant — the modifiers that matter, the denials we prevent, and the guidelines we follow.
Key modifiers
- RT/LT
Identifies the surgical site side when a procedure crosses over to a medical claim.
- 50
Reports a bilateral procedure performed on both sides in one session.
- GA
Indicates the patient signed a waiver acknowledging possible non-coverage.
- 59
Separates distinct procedures on the same date that edits would otherwise bundle.
Common denials & fixes
Major or surgical work performed without pre-authorization.
Obtain and file predetermination for crowns, surgery, and prosthetics before treatment begins.
Service exceeds the plan's frequency limit, such as cleanings per year.
Verify benefit history and frequency limits at scheduling to set patient expectations.
Medical crossover claim denied for lack of medical necessity.
Support surgical or trauma-related procedures with medical documentation and the correct diagnosis when billing medical.
Claim rejected for missing tooth number, surface, or quadrant.
Capture complete tooth and area detail on the CDT claim to satisfy adjudication requirements.
Billing guidelines
- Report each service with accurate tooth, surface, and quadrant detail.
- Secure predetermination for major restorative and surgical procedures.
- Route eligible surgical and trauma cases to medical crossover with proper CPT and diagnosis.
- Track annual maximums and frequency limits before scheduling covered services.
End-to-End
What we handle for Dental Billing
A complete revenue cycle service tailored to your specialty.
Specialty Coding
Certified, specialty-trained coders.
Charge Entry & Claims
Clean, accurate claim submission.
Payment Posting
ERA/EOB posting and reconciliation.
Denial & AR Management
Appeals and aggressive AR recovery.
Reporting & Analytics
Real-time KPIs and insights.
98%
Clean claim rate
30%
Average revenue lift
24/7
Operations coverage
HIPAA
Compliant processes
FAQ
Dental Billing billing — FAQs
Yes — our certified coders are trained on specialty-specific rules, code sets, and payer policies, and we assign coders with experience in your specialty.
We work in your current practice management system and EHR, so your workflows and reporting stay intact while we handle the billing.
Through accurate specialty coding, front-end eligibility checks, clean claim submission, and relentless denial and AR follow-up — typically lifting first-pass acceptance and net collections.
Always. We use strict access controls, encryption, signed BAAs, and audit trails to protect patient data.
More Specialties
Other specialties we bill for
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