MO HealthNet Provider Hot Tips

The MO HealthNet Division provides hot tips to providers to assist them in receiving timely reimbursement for services provided. Please share these hot tips with your billing staff.

2017 Provider Tips

Dental Billing

Adult Dental Codes

Dental Examination:

X-rays

The following codes are covered for adults:

Sedation

Note:  May use Propofol, but only at the Moderate level of sedation.

Adults: Medical Necessity Patients

Note: You must have adequate documentation of the patient’s Medical Necessity and have a physician’s referral in the participant’s file.

Patients 0-21years
Common Errors

Note: Only 1 allowed per Date of Service

Adults and Patients 0-21years
Prior-authorization

Note: Please submit periodontal charting for the above codes or any periodontal procedure codes

Important Billing Reminders

Adequate Documentation

Section 2.3.A of the Dental Provider Manual
13 CSR 70-3.030, Section (2)(A) defines “adequate documentation” and “adequate medical records” as follows: