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References - Procedure Types

Procedure Types are defined by insurance companies, but are generally universal across most carriers. Some examples of Procedure Types include Diagnostic, Restorative, Preventive, Labs, Radiography, and so on. 

Note: Procedure Types are separate from Procedure Categories, which are used to track production through the Production by Procedure Category report. As an internal tool, Procedure Categories may set up to track different types of restoration procedures, new patient visits versus established patients, and so on.

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Managing Procedure Types
New Insurance Types may be added by selecting the Procedure Types node, then clicking on the green plus in the sidebar. You can then name the Procedure Type by entering the name into the Description field. In MacPractice DDS, it is possible to designate if the Procedure Type is a Dental or Orthodontic procedure.


If the Localization Preference Use Canadian Claim Fields has been enabled, the Procedure Type Reference will also include a CDA Code field.

In MacPractice DDS, designate a Procedure Type as a Dental Procedure Type or an Orthodontic Procedure Type within the Reference. Procedures associated to a Dental Procedure Type will reduce the Remaining Coverage field as they are estimated, while procedures associated to an Orthodontic Procedure Type will reduce the Orthodontic Remaining Coverage as they are estimated.

The common Procedure Types for Medical and Dental codes are listed below. Each insurance plan may use different percentage amounts and types. Additional Procedure Types may be added for the variations of individual insurance plans.

Medical

  • Anesthesia (00100-01999; 99100-99140)
  • Surgery (10021 to 69990)
  • Radiology (70010 to 79999)
  • Pathology and Lab (80047 to 89398)
  • Medicine (90281 to 99199 and 99500 to 99607)
  • Evaluation & Management (99201 to 99499)
  • HCPCS (A0000 to Z9999)
Dental ADA
  • Diagnostic (D0100-D0999)
  • Preventative (D1000-D1999)
  • Restorative (D2000-D2999)
  • Endodontics (D3000-D3999)
  • Periodontics (D4000-D4999)
  • Prosthodontics, Removable (D5000-D5899)
  • Maxillofacial Prosthetics (D5900-D5999)
  • Implant Services (D6000-D6199)
  • Prosthodontics, Fixed (D6200-D6999)
  • Oral and Maxillofacial Surgery (D7000-D7999)
  • Orthodontics (D8000-D8999)
  • Adjunctive General Services (D9000-D9999)

Dental CDA

  • Diagnostic (00011-05201)
  • Radiographs, CBCT (07011-07043)
  • Preventative (11101-16519)
  • Restorative (20111-29319)
  • Endodontics (33221-39313)
  • Prosthodontics, Removable (51101-57402)
  • Prosthodontics, Fixed (62101-69812)
  • Oral and Maxillofacial Surgery (71101-79962)
  • Orthodontics (80601-89301)
  • Adjunctive General Services (91121-99555)
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