UOR 2018 Credits: 1 Course Code: ED48K6 CA #: 01-4527-15277 Most dental professionals are caring, ethical, and honest. They would never knowingly perpetrate any type of dental fraud, abuse, or scam. Patients and possibly others you work with may ask if codes can be alternated, treatment dates changed, and more to increase dental benefit coverage. This is more than an ethical dilemma. We have worked too long and hard to complete our education and licensure to allow fraud and abuse to jeopardize success. Procedure codes are part of every patient encounter, even if there are no dental benefits. Without knowledge of the codes and how they are being applied, there is a likelihood of fraud being committed. 1. Protect against fraud being committed, even by accident 2. Guard against misuse of the game-changing D4346 gingival inflammation code 3. Grasp the reasons why carriers can remap (down-code) but dental practices cannot 4. Identify how dental hygienists need to create simple and effective “Twitter-style” dental-medical necessity narratives
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