Has your dental office considered telemedicine for your Dental Sleep Medicine (DSM) and Temporomandibular Joint (TMJ) screenings?  Telemedicine visits for dental practices are increasing, and rightly so!  Research reports that telehealth encounters deliver positive outcomes at the same level as face-to-face encounters for screening visits, particularly for chronic conditions. Read our short Q & A by cross-coding icon, Rose Nierman, to learn more:

Q: Why is telemedicine such a good fit for the dental office for screening sleep?

A: Telemedicine encounters rely on communication, counseling, and monitoring. Screening questions to evaluate the risk of sleep-related breathing disorder (SRBD) can easily be incorporated into a remote encounter.

Q: What is the process to schedule a patient for the telemedicine visit?

A: If the patient is already diagnosed, revisit the chief complaint. Interview for History of Present Illness (HPI) and discuss reasons they seek OAT.  Have the patient send you a copy of their insurance card.  Get a verbal commitment for payment and credit card information.

Q: What about referrals?

A: After the DSM visit, you can refer to a sleep physician remotely.  According to the American Academy of Sleep Medicine (AASM), telemedicine is a means for advancing patient health by improving access to the expertise of board-certified sleep medicine physicians.

Q: Can we send a temporary appliance to the patient?

A: According to Airway Management, out of Dallas, a temporary appliance such as the MyTAP can be sent to the patient as a trial until a custom-made appliance can be delivered. The dental office can ship the temporary device to the patient with instructions. Another telemedicine visit can be used to assist the patient in the steps for the boil and bite temporary appliance.

Q: How Do I Code Telemedicine to Medical?

A: Coding varies by insurance carriers, so check with insurance plans to determine the coding guidelines. Many commercial carriers accept the same evaluation and management (E&M) codes as you would for a face-to-face encounter.  Example: s CPT 99202 for a new patient level 2 E&M visit.

Additionally, the dental practice can indicate that the encounter was a telemedicine visit by appending a CPT modifier (modifier 95) and/or using a place of service code that specifies telemedicine (place of service code 02).

Other medical insurers utilize the newer 2020 CPT telemedicine codes:

99421            Online digital evaluation and management service, for an established patient, for up to 7 days cumulative time during the 7 days; 5-10 minutes

99422            11—20 minutes

99423            21 or more minutes

Furthermore, documentation is crucial to support the billing of screenings and consults, for Obstructive Sleep Apnea.  Nierman Practice Management’s (NPM) DentalWriter™ questionnaire and exam forms generate a SOAP narrative report.  The questionnaire can be easily completed from an online link by the patient. And easily entered into DentalWriter’s dedicated questionnaire and exam to generate a SOAP note.

By Rose Nierman, Founder & CEO, Nierman Practice Management

About Rose Nierman

Rose Nierman’s Online Medical-Billing Course series, Nierman CE+, and her live cross-coding continuing education courses have helped thousands of dental practices learn and apply medical billing. Her company, Nierman Practice Management, created DentalWriter software to generate medical claims and narrative reports, and Nierman Medical Billing Service to handle the insurance communication for clients. Rose and her company have been dedicated to helping dentists and their teams for 32 years. For more information, email us at contactus@dentalwriter.com or call 800-879-6468.

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