Providers who send both medical and dental claims, such as oral and maxillofacial surgeons, may need to use a combination of ADA and CPT codes in the office fee schedule. In some cases, the dental code has an equivalent medical code that simply needs to be used when submitting medical claims. By utilizing the cross code feature in the fee schedule, MacPractice will use the appropriate code, just based on whichever claim form you print/submit. This ensures you do not have to duplicate procedures in your patient's ledger or in your fee schedule.
This article assumes you are running MacPractice DDS. For MD, DC, & 20/20 the steps remain the same, however, the dental or ADA code is entered as the Cross Code and the medical or CPT code is the default Code.
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For paper claims, the office will first need to enable both dental and medical claim forms. This is done in the References ability by selecting the Forms node in the sidebar.
Select the CMS 1500 NPI Only form and make sure the Form Active checkbox is checked. Save when you are finished.
If your medical carriers request legacy PIN numbers on your claims, you may also decide to enable the CMS 1500 NPI and Legacy form. If you have not already activated your ADA 2019 form, you may do so at this time as well.
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For electronic claims, you will need both the Capario_Dental eClaims template and the Proxymed medical eClaims template. Sending medical eClaims requires separate payer enrollments from Dental eClaims.
Contact the MacPractice Enrollments department by email at enrollments@macpractice.com to begin payer enrollments with your clearinghouse. These templates will be installed during your eClaims training by a MacPractice representative.
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