Dental Claims and Coding Exchange Session 2

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Dental Claims Topic: ERISA (Self-Funded Plans)

• Questions regarding employer-sponsored self-funded dental plans and how the Employee Retirement Income Security Act (ERISA) preempts state insurance laws, particularly in situations involving non-covered services, payment disputes, or billing limitations.

Coding Exchange Topic: Scaling and Root Planing vs. Prophylaxis

• Questions about when periodontal therapy codes (D4341/D4342) are appropriate
  instead of routine prophylaxis (D1110), including documentation requirements for
  periodontal disease.

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