Saving Lives with Oral ID for Cancer Screening
First off, let me start by saying that I am not a clinician, I am not an engineer, and I am not a representative for any oral cancer screening companies. I am a practice manager introducing a revenue opportunity to your office.
Your dentist or hygienist is already performing a visual oral cancer screening as part of each patient exam. They are looking for precancerous and abnormal tissues, which is a standard of care for each patient evaluation.
But you are not a regular office! You are the best dental practice in town that cares more about your patients than most.
Oral Cancer Statistics
Robert Whitman is co-founder of Forward Science, manufacturer of the OralID® enhanced oral cancer screening device.
Even though we have used the device for many years, I did not realize WHY we were doing it. After listening to Mr. Whitman speak about their device and the oral cancer screening process, I better understand the reason behind the screening and the cost associated with this patient service.
Approximately 1 in 2 men and 1 in 3 women will develop some type of cancer. Cancer is the #1 killer in the world. Many cancers show a decrease in cases but not oral cancer, where there is a steady increase.
The standard of care states that we should screen people above the age of 40, who use tobacco and/or alcohol, and who have a family history of cancer. But 60% of diagnosed people do not fall into any of those categories. Oral cancer is the most deforming form of cancer and with this comes a higher suicide rate. Mr. Whitman’s webinar, “Forward Science to watch the Sex, Drugs & Oral Cancer” is highly informative, and I recommend that you seek it out.
We added Oral ID in our office years ago. But we don’t use it simply because of its added revenue, but because of the lives we could save. We have had to perform a few biopsies, but so far only one patient had oral cancer. He did end up requiring surgery, which include the removal of half his tongue and speech therapy, but it could have been much worse.
There is a billable code for Oral Cancer Screening: D0431. The CDT 2023 reads for code D0431 as an adjunctive pre-diagnostic test that aids in the detection of mucosal abnormalities, including premalignant and malignant lesions, not to include cytology or biopsy procedures. With all that said, you must add a little narrative to the insurance claim that Oral ID was used as the tool for D0431. Some insurance companies have started paying for this procedure. In our office, we screen twice per year but only charge the patient once per year.
At first, the patients did not understand why we are doing this “new thing” during their visit. But once we explained why, they understand. We now have patients who call us just for an Oral Cancer Screening appointment.
Let’s do some quick math. Say you decide to charge $20 for D0431 for each hygiene patient that is scheduled. Eight patients at $20 = $160 per hygiene schedule. Your hygienist is scheduled, say, 16 days per month; that would be $2,560 per month in added revenue per hygienist. We have found that most of our PPOs allow $30-$57 for the code. Please check with your insurance for coverage and fees.
If you have not started using the code D0431, you should revisit this service and its value not only for the added revenue for the practice, but the health of your patients.
About the Author
Lisa Lash, FAADOM is a Practice Manager with Associates in Family Dentistry in Aurora, Colorado, and has worked in dentistry for over 25 years. In 2018, Lisa achieved her AADOM Fellowship, (FAADOM) designation. She enjoys traveling each year to the AADOM conferences to see the “tribe” of wonderful members she has met along the way. Away from work, Lisa has always been a “team mom” for her two children’s sports teams, or you may find her and her husband of 24 years traveling to watch their son play college lacrosse.