Wiki BH for dental screenings?

[Sovacool]

I work in an FQHC that has FP, Psychologist, and Dental. The psychologist wants to see HIV patients because they are not being adherent to getting dental screenings annual. The want a dx for that, thoughts?

 

[thomas7331]

Of course it's difficult to come up with a code without seeing documentation. Z91.19 is the general code for non-compliance with medical treatment recommendations which sounds close to what you're describing, but in this scenario I think that code will give you trouble with the payers if billed as a primary diagnosis and/or with behavioral health services. You can code that a patient is non-compliant, but payers are going to want to know what problem is being treated with that service. I think I would advise the providers that they would need to document specifically what the patient's problem is, i.e. the provider's assessment of the root cause of the patient's not getting their dental screenings and the actual condition that is diagnosed and being treated by the psychologist, and use the corresponding code to support the necessity and payment for the encounter.

 

[Sovacool]

Thank you that was very helpful.