Jan. 2020


TST Advancing the Industry

Imagine the dental benefits industry, complete with quality measures, diagnostic terms, and abundant data to predict outcomes, guide plan designs and more. While this concept may seem unrealistic and futuristic, the reality is closer than you think, thanks to the work of NADP Terminology, Standards and Transaction (TST) Sub-Workgroups, which include:

  • Diagnostic Terminology Sub-WorkGroup (DT SWG)
  • DQA (Dental Quality Alliance) SWG
  • Codes SWG

DT SWG provides expertise and direction for NADP’s involvement with SNOMED (Systematized Nomenclature of Medicine), the international group overseeing the development of diagnosis terms for dental conditions. Through participation in this group, NADP has learned the processes, procedures and politics necessary to advance our members point-of-view. For 2020, DT SWG will concentrate on monitoring and developing terminology that is right for the U.S. dental benefits industry and continue to ask “Are plans on the verge of accepting measures and diagnostic terms? How are we working on getting data on outcomes?”

In addition, NADP’s participation in SNOMED provides the invaluable opportunity to track the progress of other country’s introduction and implementation of dental diagnostic terms. Through this unique opportunity, NADP can learn from their successes and mistakes and how it can transfer for use in the U.S. So, when it’s time to introduce diagnostic terms, the transition can advance quickly.

In addition, DT SWG will focus on creating a workplan to evaluate NADP’s position with regards to requiring and/or using diagnostic terminology on all claims.

DQA SWG volunteers steer NADP’s participation in the Dental Quality Alliance, established by the Centers for Medicare and Medicaid (CMS). Moving forward, the DQA SWG will be more proactive in proposing new measures, while also taking into consideration the needs of dental payers and the impact of new measures.

While the DT & DQA sub-workgroups are separate entities, the volunteers work in concert under the TST umbrella to advance their goals because they know that everything hinges on the establishment of diagnostic terms. Although the development of diagnostic terms and quality measures may seem slow to emerge, when compared to the medical field, dental is moving at lightning speed. DQA produced its first set of measures in five years as compared to more than a decade for medical measures. Although diagnostic terms have developed at a slower pace, progress has been made.

In addition to the advancements by the DQA & DT SWGs, the Codes SWG continues to refine the procedural codes (CDT-Current Dental Terminology) through its participation on the American Dental Association’s Code Maintenance Committee. Codes SWG members are recognized as experts in their field. Because of this, the ADA requests review of the new Code sets by NADP before releasing them. This also results in NADP licensed members receiving the ASCII file of new code sets weeks ahead of other licensees and organizations.

For more information about TST, contact NADP Deputy Director Timothy L. Brown (972.458.6998 x104).




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