
Episode #109
Ep 109: Dental Coding, Fraud & the OPA: What Every Dental Professional Should Know
Dental Coding, Fraud & the OPA: What Every Dental Professional Should Know Dental codes might not sound exciting—but using the wrong one could have much bigger consequences than you realize. In this episode of Straight Up With Steph®, I’m joined by dental hygienist and coding expert Kathy Forbes, RDH, BS, FADHA, for an eye-opening conversation about CDT codes, insurance, fraud, and why dental professionals need to understand exactly what they’re documenting and billing. Kathy explains why simply choosing the code insurance will pay for can become a serious problem—even when the intention is to help the patient. We also dig into the descriptors behind CDT codes, why they matter just as much as the code itself, and the surprising lack of coding education many hygienists and dentists receive. Then we get into one of the biggest conversations happening in dental hygiene right now: the Oral Preventive Assistant (OPA). If an OPA is only permitted to scale supragingivally, can an office bill a traditional prophylaxis code? Kathy explains why the current descriptor creates a potential problem and what would need to change. We also discuss: • Common coding mistakes dental offices make without realizing it • Why choosing a code based on insurance coverage can cross an ethical or legal line • Why there technically isn't a “cleaning” code • The difference between a code number, title, and descriptor • Why CDT descriptors can change from year to year • Why hygienists currently lack a voting seat on the Code Maintenance Committee • How new treatments like desiccation therapy and non-fluoride varnishes are coded • How using 999 codes can help demonstrate the need for future procedure codes • The potential coding problem with supragingival-only scaling and the OPA • Why assisted hygiene may offer another solution to the dental hygiene shortage • How medical billing could become a bigger part of dentistry’s future If you work in dentistry, understanding coding isn't just the business team's responsibility. What you document and what gets submitted can affect your patients, your practice, and potentially even your license. Share this episode with a hygienist, dentist, assistant, or practice owner who needs to hear this conversation. To watch on YouTube, click here OPA Podcast Topics Discussed: dental coding, CDT codes, dental hygiene codes, D1110, dental prophylaxis, dental insurance, dental billing fraud, OPA dental, Oral Preventive Assistant, dental hygienist, assisted hygiene, dental insurance billing About Kathy Connect with Kathy: Email: kathysforbes@gmail.com Website: https://www.kathysforbes.com/ Disclaimer: The opinions expressed by guests on this podcast are their own and do not necessarily reflect the views of Polished Posture. The information shared in this podcast is for educational and entertainment purposes only and should not be considered medical advice. Always consult a qualified healthcare professional for any health concerns or before making significant lifestyle changes. Click for Hygiene Month Sale (Code POLISH200 for $200 off cordless polishers) (sale ends 10/31/26; discounts cannot be combined) To connect with me: Polished Posture Club ➡️ Instagram My Website Email: stephanie@polishedposture.net Newsletter signup






