AADOM QUICKcast: Top 5 Coding Errors Costing You Time & Money – And How to Fix Them!
Video Description:
Coding mistakes can lead to unnecessary claim denials, delayed payments, and lost revenue for your practice. In this 30-minute QUICKcast, we’ll uncover the five most common coding errors that are draining your bottom line and show you how to correct them. Learn the essential tools and strategies that will help you navigate CDT codes with confidence, minimize denials, and maximize reimbursements. Don’t let preventable mistakes hold your practice back—get the coding clarity you need today!
Course Learning Objectives:
- Identify the top five coding errors that cost you time and money
- Learn how to use updated coding resources to prevent denials and delays
- Code with Confidence in 2025 with a complimentary copy of our CDT Quick Reference Guide
- Discover how to take the guesswork out of correct coding and reimbursement, setting fees, and PPO feasibility/analysis
Top 5 Coding Errors Costing You Time & Money – And How to Fix Them!
By James DiMarino, DMD, MSEd, CDC, FACD
Chief Executive Officer | Practice Booster
In the fast-paced world of dental billing and insurance administration, coding mistakes can cost practices thousands of dollars annually. These errors can lead to claim denials, delayed payments, and lost revenue—frustrating both providers and patients.
The good news? With a solid understanding of common coding pitfalls and the right resources, you can dramatically improve claim acceptance rates, streamline billing, and enhance your practice’s financial health.
In this article, we’ll explore the top five coding errors that are costing your practice time and money—along with actionable solutions to correct them.
1. Misuse of Nomenclature or Descriptor
The Mistake:
One of the most common coding errors occurs when dental teams use a CDT code incorrectly based on its nomenclature or descriptor. This could mean selecting a procedure code that sounds similar but doesn’t accurately reflect the treatment provided.
Why It’s Costly:
Incorrect coding can lead to claim denials, audits, and compliance issues. Insurance payors carefully review claims to ensure that the treatment provided aligns with the CDT code description, and missteps can result in lost revenue or even penalties.
The Fix:
➔ Always verify the CDT code’s full nomenclature and descriptor before submitting a claim.
➔ Use the most current CDT coding resources, such as Practice Booster’s Online Code Advisor, or Dental Coding With Confidence manual to ensure accuracy.
➔ Train your team regularly on proper code selection to prevent recurring errors.
2. Incorrect Arch or Quadrant Selection
The Mistake:
Submitting a claim with the wrong quadrant or arch is a surprisingly frequent error. For instance, submitting a claim for D4341 (periodontal scaling and root planing – four or more teeth per quadrant) but indicating the quadrant as UL/LL/UR/LR instead of the corresponding area of the oral cavity indicated in the ADA Dental Claim Form Instructions as 10/20/30/40 can trigger a delay or denial.
Why It’s Costly:
Payor systems are designed to read the claim form as indicated in the ADA Dental Claim Form Instructions. If the arch or quadrant doesn’t match, it is essentially submitting a claim in a different language resulting in payors delaying the claim (pending additional information) or a claim denial which consequently delays payment.
The Fix:
➔ Double-check the treatment plan and clinical documentation before submitting claims.
➔ Leverage dental practice management software to ensure the correct arch/quadrant is applied.
➔ Implement a claim review process where a second team member verifies claim accuracy prior to submission.
3. Incorrect Age Definition for Procedures
The Mistake:
Some CDT codes have age limitations, meaning reimbursement is based on the age of the patient. A common example is using D1120 (child prophylaxis) for an 11 year old pediatric patient with permanent dentition only because the plan has an age limitation of 12 years of age for D1110 (adult prophylaxis).
Why It’s Costly:
Prophylaxis claims should be reported based on the dentition of the patient, regardless of plan limitations. Always code for what you do and let the payor remap the D1110 (adult prophylaxis) to a D1120 (child prophylaxis) based on the plan’s processing policy guidelines. This is important for compliance purposes but also from a reimbursement standpoint. Submit the claim for D1110 (adult prophylaxis) with a narrative stating, “permanent dentition only.” Some payors will make an exception and allow reimbursement at the higher fee.
The Fix:
➔ Reference payor policies to confirm age-specific restrictions for each code.
➔ Use a CDT coding guide to cross-check codes for known limitations and potential workarounds.
➔ Create an internal cheat sheet for your practice that highlights age-restricted codes for easy reference.
4. Use of Expired or Deleted Codes
The Mistake:
Each year, the American Dental Association (ADA) updates the CDT code set, adding new codes, revising existing ones, and eliminating outdated codes. Many dental practices unknowingly use deleted codes that are no longer recognized by insurance payors.
Why It’s Costly:
➔ Claims with deleted codes are automatically denied.
➔ Using outdated codes delays payment and requires manual resubmission.
➔ Insurance payors may flag practices that repeatedly use expired codes, leading to compliance audits.
The Fix:
➔ Update your CDT code references annually to reflect the latest changes.
➔ Use a real-time coding tool like Code Advisor to ensure compliance.
➔ Train your team on new, deleted, and revised CDT codes each year. Consider OnDemand webinars like Exploring the 2025 CDT Code Changes with Dr. Greg Grobmyer.
5. Incorrect Evaluation Code Selection
The Mistake:
Many practices misuse evaluation codes, particularly when differentiating between comprehensive, periodic, and limited exams. For example:
➔ Using D0150 (comprehensive oral evaluation – new or established patient) for a new patient, when D0180 (comprehensive periodontal evaluation – new or established patient) may be more appropriate.
➔ Using D0120 (periodic oral evaluation – established patient) for a recare patient, when D0180 (comprehensive periodontal evaluation – new or established patient) may be more appropriate.
➔ Using D0140 (limited oral evaluation – problem focused) when D9110 (palliative treatment of dental pain – per visit) may be more appropriate.
Why It’s Costly:
Misuse of evaluation codes can lead to:
➔ Claim denials due to frequency limitations (e.g., D0140 may be included in the plan’s frequency limitation for evaluations)
➔ Lower reimbursement
➔ Reduced patient benefits, preventing them from receiving coverage for future visits
The Fix:
➔ Match evaluation codes precisely to the nature of the evaluation/treatment performed
➔ Check frequency limitations before submitting claims
➔ Use a coding reference guide like Code Advisor, or Dental Coding With Confidence to ensure proper code selection.
How to Prevent These Costly Errors Moving Forward
1. Utilize a Comprehensive Coding Resource
The Practice Booster Code Advisor, and Dental Coding With Confidence are invaluable tools that help practices:
✔ Prevent coding errors before claim submission
✔ Identify documentation requirements
✔ Find the correct narrative wording to reduce denials
2. Implement a Claim Review Process
Before submitting claims, perform an internal audit to catch common coding mistakes. Having a second set of eyes reviewing claims can reduce errors significantly.
3. Stay Up to Date with CDT Code Changes
CDT codes change every year! Make sure your team is educated on the latest CDT updates, new codes, and revisions to avoid using outdated codes.
4. Train Your Team Regularly
Ongoing education is critical for accurate coding. Investing in training programs, webinars, and workshops will help your team stay compliant and confident in their coding practices.
Final Thoughts
Mistakes in coding don’t just slow down reimbursements—they impact cash flow, compliance, and overall practice efficiency. By addressing these top five coding errors, dental teams can increase revenue, prevent unnecessary claim denials, and enhance their financial stability.
Don’t let simple coding mistakes drain your profitability. Stay proactive, stay educated, and code with confidence in 2025!
For more expert insights and resources, check out dentalcoding.com or connect with us on social media, or email info@practicebooster.com.
Sponsored by: Practice Booster
Dr. Jim DiMarino is an international speaker and the Chief Executive Officer at Practice Booster and eAssist Publishing, LLC. He holds a dental degree and master’s degree in education from the University of Pennsylvania. He completed a General Practice Residency, and became a solopreneur practicing general dentistry, all while researching and implementing advanced dental technologies and consulting as a Dentrix and Schick trainer. Dr. DiMarino has worked in the dental insurance industry as a dental claims reviewer, a State Dental Director, and as a National Dental Director. In 2018 he completed the certification requirements to become an AADC Certified Dental Consultant.
