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SoftDent: Understanding Transaction and Procedure Code Ranges

SoftDent: Understanding Transaction and Procedure Code Ranges

Transaction codes specify transaction types. Standard ADA procedure codes include standard dental procedures. Medical procedures are indicated by CPT codes. Explosion codes group a series of procedures that are often performed together.

  • Diagnosis codes are not maintained in the same database as transaction and procedure codes.

These ranges and any codes marked as Reserved cannot be changed. The ten code ranges are:

Code Type

Code Range

Payment Codes

1.00 - 20.99

Payment Adjustments

21.00 - 39.99

Charge Adjustments

40.00 - 60.99

Charge Codes

61.00 - 91.99

Reserved Codes

92.00 - 99.99

ADA Procedure Codes

100.00 - 9999.99

CPT Procedure Codes

10000.00 - 99999.99

Explosion Codes

100000.00 - 100999.99

Statement Text or Notes

101000.00 - 101999.99

Fee Schedule Titles

102000.00 - 102026.99

Detailed description of each code range and how it affects the software:

Tip: Customize codes by adding a two-digit extension from .00 to .89. Extensions .90 through .99 are reserved by the software and cannot be customized.

Code Type

Code Range

Description

Effect

Payment Code

  1. 1.00

Reserved Cash

The account balance is decreased.

The account collection amount is increased.

Payment Code

  1. 1.01 - 1.89

Other Cash

The account balance is decreased.

The account collection amount is increased.

Payment Code

  1. 2.00

Reserved

Insurance check

The account balance is decreased.

The account collection amount is increased.

Payment Code

  1. 2.01 - 2.89

Other insurance checks

The account balance is decreased.

The account collection amount is increased.

Payment Code

  1. 2.90

Reserved

Electronic funds transfer

The account balance is decreased.

The account collection amount is increased.

Payment Code

  1. 3.00-10.89

Checks

The account balance is decreased.

The account collection amount is increased.

Payment Code

  1. 11.00 - 20.89

Credit cards

The account balance is decreased.

The account collection amount is increased.

Payment Adjustment

  1. 21.00 - 29.89

Collection Adjustments

The account balance is decreased.

The account collection amount is increased.

Payment Adjustment

  1. 29.00

Reserved

Initial credit balance

The account balance is decreased.

The account collection amount is increased.

Payment Adjustment

  1. 29.01

Reserved

Compression starting credit balance

The account balance is decreased.

The account collection amount is increased.

Payment Adjustment

  1. 30.00 - 39.89

Collection debit adjustments

The account balance is increased.

The account collection amount is decreased.

Charge Adjustment

  1. 40.00 - 49.89

Production debit adjustments

The production amount is increased.

The account balance is increased.

Charge Adjustment

  1. 40.90

Reserved

DMO per-visit charge

The production amount is increased.

The account balance is increased.

Charge Adjustment

  1. 48.00

Reserved

Monthly budget plan charge

The production amount is increased.

The account balance is increased.

Charge Adjustment

  1. 48.01

Reserved

Budget plan production debit adjustment

The production amount is increased.

The account balance is increased.

Charge Adjustment

  1. 48.90

Reserved

Monthly ortho budget plan charge

The production amount is increased.

The account balance is increased.

Charge Adjustment

  1. 49.00

Reserved

Initial debit balance

The production amount is increased.

The account balance is increased.

Charge Adjustment

  1. 49.01

Reserved

Compression starting debit balance

The production amount is increased.

The account balance is increased.

Charge Adjustment

  1. 50.00 - 60.89

Production credit adjustments

The production amount is decreased.

The account balance is decreased.

Charge Adjustment

  1. 50.90

Reserved

Write-off adjustment

The production amount is decreased.

The account balance is decreased.

Charge Adjustment

  1. 50.91

Reserved

Risk write-off

The production amount is decreased.

The account balance is decreased.

Charge Adjustment

60

Reserved

Budget plan transfer code

The production amount is decreased.

The account balance is decreased.

Charge Code

  1. 61.00 - 91.89

General debit codes

The production amount is increased.

The account balance is increased.

Reserved Code

  1. 92.00 - 98.89

Reserved

Internal codes

N/A

Reserved Code

  1. 96.00

Reserved

Money transfer credit code

The account balance is decreased.

The collection amount is increased.

Reserved Code

  1. 96.90

Reserved

Move patient balance transfer debit code

The account balance is decreased.

The collection amount is increased.

Reserved Code

  1. 97.00

Reserved

Monthly billing charge

The production amount is increased.

The account balance is increased.

Reserved Code

  1. 98.00

Reserved

Money transfer debit code

The account balance is increased.

The collection amount is decreased.

Reserved Code

  1. 98.90

Reserved

Move patient balance transfer debit codes

The account balance is increased.

The production amount is increased.

Reserved Code

  1. 99.00 - 99.89

Reserved

Finance charges

The account balance is increased.

The production amount is increased.

ADA Procedure Code

  1. 100.00 - 9999.89

Production codes

The account balance is increased.

The production amount is increased.

CPT Procedure Code

  1. 10000.00 - 99999.89

Medical codes

The account balance is increased.

The production amount is increased.

Explosion Code

  1. 100000.00 - 100999.89

Explosion codes

N/A

Statement Text or Notes

  1. 101000.00 - 101999.99

Notes that are attached to statements

N/A

Fee Schedule Title

  1. 102000.00 - 102026.00

Fee schedules

N/A

  1. 103000.00

Reserved

Statement sent code

N/A

  1. 103000.50

Reserved

Transfer old insurance to patient code

N/A

  1. 103000.90

Reserved

Patient walkout given

N/A

  1. 103000.91

Reserved

Account walkout given

N/A

  1. 103000.92

Reserved

Recall notice sent

N/A

Labels (1)
Comments
oasisprosth

I've seen in some offices where codes can be customized to signal time unit needs for the schedule. Where in these ranges would you add those?

The time units are added to

Procedure codes: 100-9999

Medical codes: 10000-99999

Explosion codes: 100000-100999

Go to the "List" menu > select "ADA Codes" > double click the procedure code you would like to edit. On the yellow "Scheduler/Fees" tab, the "Time Units" can be entered.  Please note: a time unit is determined by the length of one line on your scheduler (either 10 or 15 minute increments) 

 

Also, in this same location you can adjust the Multi Time Units, to indicate how much additional time is needed if there are instances where you complete more than one of a specific procedure within the same appointment.  

For example: a restorative filling might be 4 time units, but for each additional filling the appointment needs to be lengthened by 2 units.  

1 filling = 4 units, 2 fillings = 6 units, 3 fillings = 8 units, etc. 

Hope this helps! 

Danelle

oasisprosth

Thanks for your response Danelle!

We are looking for time unit coding for multi assistant scheduling and assigning. I've worked in an office where we had a separate code to signify how much time was needed. We would enter the code as "020502". OR "020802". The first and last number denotes assistant time and the middle number doctor time. These codes were never meant for posting, simply a visual guide for whomever was scheduling. Then we could fill in the appropriate time units in the appointment card (12) and the appropriate assignment (AADDDDDAA). The code was deleted before posting. 

I am making an assumption that this codes would be used in Treatment Planning so that the person scheduling knows how to enter the scheduling assignment, if this assumption is not correct the answer could change.  

You can add codes into SoftDent that will serve this same purpose.  There is no specific number range you are supposed to use for these types of codes, but I personally would use 100-99999 with a modifier.    

A couple of thoughts on the codes you could create:

  • In SoftDent, we drop the preceding zero on any code created... so the two examples you gave would become 20502 and 20802.  Codes that are 5 numerical digits in length fall into the CPT/medical code range.  If you are not currently using medical codes, you could use your original codes as you did in your other office, however, I would proceed with caution in case your office ever does need to use medical coding, and those numbers end up representing a procedure.  Adding a modifier (.1 or .01) to the end of the number would prevent any coding conflict in the future.  
  • Maybe you can use the same concept, but a slightly different numbering scheme to include the modifier.  You can add codes to SD with the decimical point in place of the second zero (your original example would look like this: 205.2 = 2 units of asst/6 units of dr/2 units of asst time, 208.2 = 12 total units AADDDDDDDDAA, etc.).
  • You could add a group of codes that represent time combinations but use a completely different numbering scheme.  Ex: 9800.1 = 2/5/2; 9800.2 = 2/8/2, etc.
  • My concern with all of the above options are the number of codes you will have to create.  While you can create thousands of codes if you wish, it just seems like you will have a lot of work to create all the necessary combinations.  

I hope this information helps.  

Danelle

oasisprosth

Thanks for your help Danelle!

bwhite

This table is very helpful.  I want to add a code that can be used with our Medicaid payments.  How do I link the claim to a write off code?

dmccrory

Hello,

Write offs:

The reserved codes within SOFTDENT Software for write-off are 50.90 (PPO

Write Off) and 50.91 (Risk Write Off).

The "PPO Write Off" (50.90) code is supposed to be used to post the actual

write-off that is allowed by the insurance company once the actual

insurance check is being posted.

The "Risk Write-Off" (50.91) code is used to give the patient an

estimation of the total amount of write-off at the time of service.

Write-Off codes are also used to track the actual amount the office will

"Write Off" on certain codes due to the fact that they are a participating

provider for specific PPO plans. This allows them to track the amount of

production/collection that gets written off due to participation in these

plans.

Code 50.90 is coded within SOFTDENT Software to be reserved as a write off

code and will be displayed properly on daysheets as a PPO write off. The

Amount Due to PPO = Total dollar amount posted to PPO write-offs (code

50.90).

The following steps can be taken to post write offs automatically on PPO

plans.

1. Click List in the main menu bar.

2. Select Ins. Plan.

3. Double-click on the desired PPO plan.

4. Put a check in the box labeled "Post Write Off at Time of Service".

5. Click OK to save the changes.

Medical code:

In order to submit certain ADA procedures to medical insurance, they must

first be linked to a medical code equivalent, as medical insurance

utilizes a different procedure code set. To link an ADA code to a CPT

medical code, perform the following steps. Please note that the office

must know what medical code equivalent should be matched with the ADA code

being submitted.

Adding a CPT Code to the ADA / CPT Diagnosis Codes Listing

CPT Codes are numbered from 10000.00 Through 99999.99. When adding a code

falling within this range, SOFTDENT Software will automatically set it as

a CPT Code.

1. Click List and select ADA Codes.

2. Click Add to add a new CPT code.

3. Enter the CPT code number in the Add ADA / Transaction Codes window.

4. Click OK. The Transaction Code window will be displayed.

5. Enter the desired code description.

6. Select the type of service from the "Medical Information" section of

the window.

7. Select the class of service from the "Code Class" section of the

window.

The default code classes are:

Anesthesia

Surgery

Radiology

Pathology / Lab

Medicine

Consultation

8. Click OK once the desired information is entered.

Linking An ADA Code to a CPT Code

1. Click List and select ADA --> CPT.

2. Enter the ADA code number that is to be linked in the field labeled

"ADA".

3. Click Add.

4. Enter the CPT code to which the ADA code is to be linked into the field

labeled "CPT Code".

5. Click OK to link the code.

David McCrory| Technical Support Analyst

www.carestreamdental.com

Find us at Twitter | Facebook

http://www.carestreamdental.com/us/en/forms/dental-events

bwhite

Thanks for your quick response.  I was able to follow until #4.  I don't see the "Post Write off at Time of Service".

The following steps can be taken to post write offs automatically on PPO

plans.

 

1. Click List in the main menu bar.

2. Select Ins. Plan.

3. Double-click on the desired PPO plan.

4. Put a check in the box labeled "Post Write Off at Time of Service".

5. Click OK to save the changes.

We are a mobile program so we don't process our Medicaid claims on the date of service.  How will this option affect us if we are not submitting on the same day of service?

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