Free Narratives and Attachment Guide for Dental Insurance Claims (2024)

Part 1: Narratives and Attachments

To say this training was a labor of love is NO JOKE! I am so excited to share with you the best tips for getting your claims paid and a couple of tips and tricks we have found helpful over the years. (PLUS insurance company-specific requirements).

This hot topic is big and we never want content that takes more than 10 minutes to learn so, here is part ONE. Come back for part two soon.

First, dental billing is waaaayyyyy different than medical billing. The coding and sending of claims is a unique process. It requires specific attachments, narratives, and information not readily needed on medical claims. Dental coding is based on Current Dental Terminology codes which are governed by the American Dental Association. Each year, the ADA provides code updates, revisions, deletions, and more. Staying up to date with these will be the first step to ensuring your claims are always submitted properly.

Most dentists do not readily outsource their dental billing and coding procedures and we highly recommend this. Oftentimes, we see tiny breaks in processes of narratives, attachments, and claim submissions which can be avoided with just a few tweaks. Dental billing is a position that should be maintained by a specific position in the office rather than a blanket job for everyone to have a hand in. This training will provide your dental office with those very tweaks needed to improve claims and close the revenue cycle much faster.

Narratives + Attachments

Let's break this down by category and what you need to submit with claims.

You might be like me and find that our doctors do not always put a clinical note in that helps us get a claim paid. So, we are going to help you with some templates you can use. No, we don't guarantee anything however if clinical notes are sparse, these templates can work wonders. Always check with your owner before implementing anything you find here.

Alrighty... let's go...

Osseous Surgery:

Attachments: Intraoral photos if possible

Narrative: Necessary to detoxify the root surface and to prevent further bone loss.

4263 +/or 4265 Bone Graft Replacement:

Attachments: Intraoral photos if possible

Narrative:

Necessary to potentiate new attachment and to promote bone regeneration.

4341/4342 SRP- Scaling and Root Planing:

Attachments: FMS (Full Mouth Series) and Periodontal Charting/Perio Chart)

FMX and PERIO CHART attached.

Narrative: Scaling and Root Planing necessary to remove subgingival microbiota both alive microorganisms and dead to prevent further bone loss.

Optional Narrative: The patient has BOB, inflammation, unattached gingiva, with puffing interdental papilla, 5mm pockets in each quad or higher, sub and supra calc with tartar, poor OH. Needed due to gingival migration and bone loss. The patient presents heavy deposits and severe gingivitis. To treat patients needed to be anesthetized for a through S/RP. Radiographs show loss of crestal bone and to prevent further bone loss and attachment S/RP was diagnosed to which the patient agreed to treat.

4355 Full Mouth Debridement:

Attachments: FMS + Periodontal Charting)

Narrative: Full Mouth Debridement is necessary to remove heavy build-up of plaque and calculus in order to perform a comprehensive examination in the future.

D4910 Periodontal Maintenance Treatment:

Attachments: Periodontal Charting/Perio Chart

Narrative: For CIGNA AND METLIFE (mandatory documentation): Include the SPR Hx(history) as narrative.

Ex: SPR done on (mm/dd/yyyy) at UR and LR.

Gingivectomy:

Attachments: Intraoral photos if possible

Narrative: Gingivectomy is necessary due to excision of the soft tissue wall surrounding a gum pocket in [Teeth #'s].