How OD decides treatment area for procedure codes?

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manish.bhalodi.tech9
Posts: 7
Joined: Tue Nov 16, 2021 7:25 am

How OD decides treatment area for procedure codes?

Post by manish.bhalodi.tech9 » Tue Apr 04, 2023 2:36 am

Hello Open Dental Team,

I am trying to understand, How OD Team decides to set Treatment Area for the procedure code. I found differences between ADA Recommendation & OD Treatment Area in the procedure code table.

Below is the latest ADA's Procedure code Treatment area pdf file.
https://www.ada.org/-/media/project/ada ... 023jan.pdf

I found that

For 'D0140', 'D0145', 'D0150', 'D0160', 'D0170', 'D0310', and 'D0320'
ADA - Does not recommend putting anything
Open dental - Treatment area to Mouth

For D0220 & D0230
ADA - Does recommend putting Tooth or Tooth Range
Open dental - Treatment area to Tooth Only

For D0660
ADA - Does recommend putting Tooth or Tooth Range
Open dental - Treatment area to Mouth

For D5875, D5876
ADA - Does recommend putting Arch
Open dental - Treatment area to Mouth

For 'D0240', 'D0250', 'D0251', 'D0270', 'D0272', 'D0273', 'D0274', 'D0373', 'D0705', 'D0706'
ADA - Does recommend putting Tooth Range
Open dental - Treatment area to Mouth Or Arch

For D1510, 1520
ADA - Does recommend putting Tooth, Tooth Range, Or Quadrant
Open dental - Treatment area to Tooth

Other so many codes have this mismatch.

For ADA's Tooth and Tooth Range recommendation, OD recommends only Tooth and If there multiple recommendations from ADA then OD set Mouth as a recommendation. Is this a pattern? or How OD decides?

Let me know, If this is not the correct category to ask this question.
Thank You,
Manish

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jordansparks
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Re: How OD decides treatment area for procedure codes?

Post by jordansparks » Thu Apr 06, 2023 6:33 pm

They are all just recommendations. There's a lot of flexibility and each insurance company also handles them differently.
For 'D0140', 'D0145', 'D0150', 'D0160', 'D0170', 'D0310', and 'D0320'
ADA - Does not recommend putting anything
Open dental - Treatment area to Mouth
Well, "nothing" is really synonymous with "mouth". For example, D0140 you are examining the mouth.
For D0220 & D0230
ADA - Does recommend putting Tooth or Tooth Range
Open dental - Treatment area to Tooth Only
This means you have a choice. If you don't like tooth, you can change it to tooth range.
For D0660
ADA - Does recommend putting Tooth or Tooth Range
Open dental - Treatment area to Mouth
Did you mean D0600 (caries testing)? I would say we are wrong on this one, but it's very easy for you to change it to tooth.
For D5875, D5876
ADA - Does recommend putting Arch
Open dental - Treatment area to Mouth
Denture modification: You should change it to arch.
For 'D0240', 'D0250', 'D0251', 'D0270', 'D0272', 'D0273', 'D0274', 'D0373', 'D0705', 'D0706'
ADA - Does recommend putting Tooth Range
Open dental - Treatment area to Mouth Or Arch
It's really up to you. Tooth range makes sense, but insurance won't deny payment if you just leave it mouth. Sometimes it's easier to not have to be forced to put in a tooth range because that wastes time.
For D1510, 1520
ADA - Does recommend putting Tooth, Tooth Range, Or Quadrant
Open dental - Treatment area to Tooth
We had to pick one. We picked tooth for you as a starting point because most fixed space maintainers go on the first permanent molar to maintain space for one tooth. By picking one tooth, we are matching the recommendation, but you can pick a different one if you want.
Jordan Sparks, DMD
http://www.opendental.com

manish.bhalodi.tech9
Posts: 7
Joined: Tue Nov 16, 2021 7:25 am

Re: How OD decides treatment area for procedure codes?

Post by manish.bhalodi.tech9 » Tue Apr 11, 2023 4:31 am

Thank you @jordansparks for the reply. I got what I need.

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