SNODENT and the future of dental EHR coding

The dental industry is rapidly changing with the introduction and adoption of dental EHRs. This technology affords us the ability to have functionality that we could have never done before on a manual level. One of the big changes that’s happening is the introduction of new, more detailed granular and sophisticated coding sets.

We are moving more toward the need for more detailed descriptions of problems and procedures. The growth of oral systemic health has fueled this, as well as the movement towards more detailed documentation regarding a patient’s problems and procedures. Also, there are changes predicted in insurance reimbursements where the payers will require more specific codes and descriptions.

This was addressed in the medical industry years ago by the integration of SNOMED CT codes. A subset of SNOMED CT, known as SNODENT, has been developed to address dental specific problems and procedures. Some of you that have looked at various dental software systems might have seen the ability to pick problems offered by the EHR, but, more commonly than not, these lists were either developed by the vendor, the practice or a combination of both and were inconsistent.

At any rate, these don’t use any kind of standard terminology. In the long run, SNODENT descriptions will be mapped to underlying ICD codes so technically you can enter problems and procedures based on descriptions and the appropriate billing codes will just flow through under the covers to claims processing.

The concept of SNODENT that has been around for a while now, is to standardize coding and present lists of problem and procedure terminology that are very detailed and granular in nature, with the goal of covering all possibilities. The first shot across the bow at bringing this into dentistry on a large scale is a requirement that dental EHRs have during their certification process. The dental software vendors are required to put hooks in their software that will integrate the SNOMED CT database and thus bring along the SNODENT codes in the process.

To get a sense of the types of terms that are being incorporated into the SNOMED/SNODENT database, here is a search tool that you can play around with: http://www.snomedbrowser.com/

Just type a dental-related problem or procedure into the search box and check out the results that come up. Note that you can also filter the results list by findings, procedure, etc. SNODENT codes and terminology are being continually developed on an international level by organizations such as the Dentistry Special Interest Group for SNOMED CT, so there will be many more terms added over time.

According to Mark Jurkovich, international chairman of this special interest group, the future of this standard is bright and will lead to more efficiency in documenting visits and interoperability between EHRs. He is also working with the ADA on improving coding for dental EHRs to improve patient documentation across the industry.

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