11/16/2016

CDT 2017 dental code changes are here


CDT 2017 is the newest version of the American Dental Association’s code on dental procedures and nomenclature. Dentists will need to prepare for the 2017 dental code changes effective Jan. 1, 2017.

Addition of D4346 fills a gap

CDA is happy to see the addition of D4346: Scaling in presence of generalized moderate or severe gingival inflammation.

Current CDT codes document procedures for a generally healthy patient with periodontal disease who has accompanying loss of attachment and bone loss. D1110 is primarily a preventative procedure for patients with generally healthy periodontium. D4341 and D4342 are therapeutic procedures and are indicated for patients who require scaling and root planning due to bone loss and subsequent loss of attachment.

Dentists have found a gap in available codes for those patients who need therapeutic treatment for generalized moderate to severe gingival inflammation, with or without pockets but exhibiting no bone loss. Finally, with the implementation of CDT code D4346, dentists can now accurately document and report these “difficult” cleanings.

It will be important to look for updates from the dental benefit plans on the processing and policy guidelines for D4346. Plans usually start sending updates on policy changes for the New Year in late October and early November. The ADA’s full D4346 code description is provided in the outline below.

There are 16 code changes, which include an addition of 11 new procedure codes, five revisions and one deletion.

New CDT 2017 procedure codes:
D0414

laboratory processing of microbial specimen to include culture and sensitivity studies, preparation and transmission or written report

D0600

non-ionizing diagnostic procedure capable of quantifying, monitoring, and recording changes in structure of enamel, dentin, and cementum

D1575

distal shoe space maintainer – fixed unilateral

D4346

scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation

 

The removal of plaque, calculus and statins from supra- and sub-gingival tooth surfaces when there is generalized moderate or severe gingival inflammation in the absence of periodontitis. It is indicated for patients who have swollen, inflamed gingiva, generalized suprabony pockets, and moderate to severe bleeding on probing. Should not be reported in conjunction with prophylaxis, scaling and root planning, or debridement procedures

D6081

scaling and debridement in the presence of inflammation or mucositis of a single implant, including cleaning of the implant surface, without flap entry and closure

D6085

Provisional implant crown

D9311

consultation with a medical health care professional

D9991

dental case management – addressing appointment

D9992

dental case management – care coordination

D9993

dental case management – motivational interviewing

D9994

dental case management – patient education to improve oral health literacy

 

CDT 2017 code revisions:
D1510

space maintainer – fixed unilateral: excludes a distal shoe space maintainer

D4263

bone replacement graft – retained natural tooth – first site in quadrant

D4264

bone replacement graft – retained natural tooth – each additional site in quadrant

D4274

mesial/distal wedge procedure, single tooth (when not performed in conjunction with surgical procedures in the same anatomical area)

D9630

drugs or medicaments dispensed in the office for home use

 

CDT 2017 code deletion:
D0290

posterior – anterior or lateral skull and facial bone survey radiographic image

Dental plans are required to recognize the current CDT codes and usually make their updates effective Jan. 1 of every year. It is important to remember that while plans are required to recognize the current CDT codes, they are not required to pay or provide benefits for the new code set. Dental offices are encouraged to reach out to the dental plans they contract with for an updated provider handbook and review them for CDT code and processing policy changes.

Copies of the CDT 2017 are available for purchase through the American Dental Association website. It is recommended all dental offices have a current copy to assist with proper claim billing.

CDA Practice Support offers hundreds of dental benefit, employment, regulatory compliance and practice management resources to CDA members as a free benefit. Visit cda.org/practicesupport to learn more about the tools available to assist member dentists with their practice.



Related Items

Under SB 137, which went into effect July 1, dentists contracted with dental plans must respond to a plan’s request for accurate directory information within 30 days or face payment delays, reimbursement reductions or termination of their participating provider agreement.

As part of a contractual commitment the dental benefit plans have with their consumers (employer groups and their employees), the plans are required to have a claims utilization review and audit process.

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