Step 3 of 8 in the billing cycle
CDT coding review and dental claim scrubbing
Before a claim goes out, a biller checks the codes, tooth numbers, surfaces and attachments against your clinical notes and the payer’s rules. AI runs the same claim through a rules check first, so the biller’s attention goes to the claims that need it.
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Completed today: D2392, posterior composite, two surfaces, tooth 19.
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Clinical note lists three surfaces (MOD). Code is for two.
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Confirmed with the note. Updated to D2393.
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Payer rules check passed. No missing fields.
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Ready to submit.
Why coding errors cost so much
Dental procedures are billed with CDT codes, the code set maintained by the American Dental Association and updated every year. Payers then add their own rules on top: which codes they bundle together, how often they pay for a service, when they downgrade to a less expensive alternative, and what documentation they want to see.
A claim with the wrong code, a missing surface or no attachment gets rejected, denied or underpaid. And some offices undercode out of caution, leaving money on the table for work they did and documented.
How we handle it
Experienced billers do the work and make the decisions. AI does the reading, checking and watching that keeps the work complete.
What our billers do
- Review completed procedures against the clinical notes before claims are created.
- Confirm codes, tooth numbers, surfaces and quadrants, and correct mismatches.
- Ask your team when a note does not support the code, instead of guessing.
- Keep up with annual CDT changes and payer policy updates.
- Share the patterns we see so your team can fix them at the source.
Where AI helps
- Suggests CDT codes from the clinical notes for the biller to confirm.
- Checks each claim against payer rules for bundling, frequency and missing fields.
- Flags claims that are missing an attachment the payer is likely to require.
- Points out procedures that appear in the notes but not on the claim.
What your office gets
- Problems caught before submission
- Mismatched codes and missing attachments are fixed before the payer ever sees the claim.
- Codes that match the documentation
- What you bill is what you did and what your notes support.
- Feedback your team can use
- Recurring issues are shared with the team so they stop happening.
What we need from your office
- Completed procedures and clinical notes in your practice management system.
- A contact on your team for quick documentation questions.
Questions about coding and claim review
Will you change our codes?
We do not change clinical decisions. When the documentation and the code do not match, we ask your team and correct the claim based on the answer, so the claim reflects what was actually done.
Does AI code our claims?
AI suggests codes and runs the rules check. A biller confirms every code before a claim is submitted.
How do you handle the yearly CDT updates?
CDT changes take effect each January 1. Our billers review the changes and update the checks our AI runs, so new and revised codes are handled correctly from the start of the year.
See where your billing is leaking.
A free billing review looks at how claims move through your office today and where revenue slips. You get a plain answer on what we would change, with no obligation.