BC Advantage - 2025 Issue 3

Dental Claims Requiring Use of ICD-10-CM Codes

Dental claims now require the use of ICD-10-CM codes. Several states (e.g., Arizona) have begun to mandate that diagnosis codes be reported along with dental codes on claim forms. For instance, if a patient's visit is due to an underlying medical condition, an ICD-10-CM code must be included. Additionally, government payors like BCBS Federal already require the use of diagnosis codes, and it is expected that other payors will adopt ICD-10-CM in the future. If you have specific questions about your state's requirements or need further guidance, consider checking with your state Medicaid or commercial dental plans. ...

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