Dental Billing and Policy Workshop
Dental Billing and Policy Workshop for MHD Providers
MO HealthNet Education and Training is hosting an in-person Dental Billing and Policy Workshop in Jefferson City. Dental providers and their staff will have the opportunity to participate in an interactive presentation with all three Managed Care Plans and the MO HealthNet Division (MHD) regarding billing practices and available resources.
Prescription Drug Monitoring Program (PDMP) Survey
Survey on the SUPPORT Act's Prescription Drug Monitoring Program Mandate
MO HealthNet is conducting a survey regarding the implementation of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act's prescription drug monitoring program mandate.
Dental Program
When completing and submitting a paper ADA Dental Claim form, dental providers should complete Field 23 with the participant’s MO HealthNet number exactly as shown on the participant's ID card. Anything other than the participant’s DCN, or leaving the field blank, will cause the claim to deny.
American Dental Association (ADA) Dental Claim Form
When completing and submitting a paper ADA Dental Claim form, dental providers should complete Field 23 with the participant’s MO HealthNet number exactly as shown on the participant's ID card. Anything other than the participant’s DCN, or leaving the field blank, will cause the claim to deny.
Correct Address for Mailing Paper Dental Claim Forms
MO HealthNet dental providers submitting paper dental claim forms for MO HealthNet fee-for-service participants, must mail claims to:
Wipro Infocrossing
P.O. Box 5600
Jefferson City, MO 65102
Paper claims sent to any other address will not be processed for payment. For additional information, reference Section 15.7 of the Dental Manual at http://manuals.momed.com/manuals/.
Fluoride Varnish During Well Child Check
Fluoride varnish is a covered service for participants age five and under, when the need is identified through an Early Periodic Screening, Diagnostic, and Treatment (EPSDT) visit. Fluoride varnish may be applied by physicians and nurse practitioners along with other medical professionals (RN, LPN, Physician Assistant) working in a physician’s office or clinic.Fluoride treatment is limited to 1 application of stannous fluoride, acid-phosphate fluoride or fluoride varnish per participant, 2 times per rolling year, per provider.
Dental Billing Tips
Dental Examination:
- D0120 – Periodic Oral Evaluation
- Not included in the Adult Dental Limited Package
- Would require a letter of medical necessity from the patient’s primary care provider The medical necessity must meet MO HealthNet policy in Section 13 of the Dental Manual.
- D0140 – Limited Oral Evaluation Problem Focused
- Code could be used with appropriate documentation of the problem.
- D0150 - Compr
Adult Dental Benefits: MO HealthNet Managed Care Participants
The MO HealthNet Division (MHD) fee-for-service (FFS) program will reimburse enrolled FFS providers for adult Managed Care participants for dates of service January 1, 2016 through June 30, 2016.
MO HealthNet Managed Care Plans will begin to reimburse adult dental services for eligible participants effective July 1, 2016.