hygiene - the international C.E. magazine of dental hygiene

16 I I C.E. article_ cross coding teriologic tests should be performed if periodontal infections are apparent. Tests that can be performed in a dental practice: • HgA1c for blood sugar • C-reactive protein (CRP) for inflammation • BANA for bacterial pathogens or their byprod- ucts • DNA for the presence of specific pathogens or for patient susceptibility to periodontal disease • TOPAS for inflammatory markers • Oral HPV testing • Diabetes testing with a glucometer — finger stickorbloodsampletakenfromaperiodontalpocket • Oral cancer screening (e.g. ViziLite) • HIV testing • Screening for cardiovascular disease (e.g. HeartScore System) • Saliva biomarker test — measures three specific biomarkers that play a role in cancer development in the oral cavity As you can see, these tests cover many possible systemicconditions.Yourpracticewillhavetodeter- minewhichstaffmembersareallowedtoadminister these tests, because your state makes regulations controlling this. Hygienists may be allowed and, if so, this may make a difference in your career. Even if hygienists are not allowed per your state’s regula- tions, your encouragement in the practice to add these tests to the practice’s procedure mix will be in- valuable to the practice. In addition, hygienists need to realize the importance of their observations and questioning of the patients in helping to move these patientstobetteroverallhealth. Thisputsanewslant on the same-old, same-old. _Power of cross coding There is, however, another area in which hygien- ists can make a significant difference in their prac- tices. Dental-medical cross coding is a cutting edge insurancesystemwherebydentalpracticescanfilea patient’smedicallynecessarydentalprocedureswith their medical plans. Implementing cross coding cre- ates greater case acceptance resulting in increased patient affordability and practice profitability. Hy- gienists can play a key role in the implementation of cross coding. Hygienists can be the communicators for cross coding in their practices by alerting the practiceofpatientswhomtheybelievearemedically compromised.Suchpatientsareexcellentcandidates for cross-coded claims. As an example, hygienists can inquire about con- ditions that might indicate that a patient has sleep apnea (Fig. 1). For those practices that treat sleep apnea, the practice would then need to refer the pa- hygiene 1_2012 Fig. 1_Photocopy of example CMS-1500 health insurance claim for treatment of sleep apnea, considered a medically necessary dental procedure that qualifies for coverage through health insurance. Many other dental procedures and tests also might qualify. But you need to know the diagnosis and procedure codes — and other nuances of the process. Fig. 2_ Blank, original CMS-1500 form, which is printed in red ink, provides spaces for at least four diagnosis codes and six procedure codes. Codes within these code systems provide further diagnostic information or details on why a procedure might have been modified. The complexity serves as fair warning that cross coding is not an easy system to implement. Fig. 1 Fig. 2