11/15/2017

Prepare for CDT 2018 dental code additions, revisions and deletions


CDA encourages all dentists to prepare for CDT 2018 dental code additions, revisions and deletions that go into effect Jan. 1, 2018. The new year will bring 18 new procedure codes, 16 revisions and three deletions.

While dental plans are required to recognize current CDT codes, it is important to keep in mind that they are not required to pay for or provide benefits for the new or revised codes. Dentists should review each dental plan’s payment and processing guidelines to determine whether benefits will be payable. Typically, plans will start sending updates about policy changes for the new year in late October and early November. 
Additionally, it is strongly recommended that dentists examine how the plans will process the two additions of the D9222 and D9239 codes and the two revisions of the D9223 and D9243 codes as they may affect the reimbursement received from the plans.

New CDT 2018 procedure codes:

  1. D0411: HbA1c in - office point of service testing
  2. D5511: repair broken complete denture base, mandibular
  3. D5512: repair broken complete denture base, maxillary
  4. D5611: repair resin partial denture base, mandibular
  5. D5612: repair resin partial denture base, maxillary
  6. D5621: repair cast partial framework , mandibular
  7. D5622: repair cast partial framework, maxillary
  8. D6096: remove broken implant retaining screw
  9. D6118: implant/abutment supported interim fixed denture for edentulous arch- mandibular
  10. D6119: implant/abutment supported interim fixed denture for edentulous arch- maxillary
  11. D7296: corticotomy - one to three teeth or tooth spaces, per quadrant
  12. D7297: corticotomy - four or more teeth or tooth spaces, per quadrant
  13. D7979: non-surgical sialolithotomy
  14. D8695: removal of fixed orthodontic appliances for reasons other than completion of treatment
  15. D9222: deep sedation/general anesthesia – first 15 minutes
  16. D9239: intravenous moderate (conscious) sedation/analgesia – first 15 minutes
  17. D9995: teledentistry – synchronous; real-time encounter
  18. D9996: teledentistry – asynchronous; information stored and forwarded to dentist for subsequent review

CDT 2018 code revisions:

  1. D1354: interim caries arresting medicament application – per tooth
  2. D1555: removal of fixed space maintainer
  3. D2740: crown - porcelain/ceramic
  4. D3320: endodontic therapy, premolar tooth (excluding final restoration)
  5. D3330: endodontic therapy, molar tooth (excluding final restoration)
  6. D3347: retreatment of previous root canal therapy - premolar
  7. D3421: apicoectomy - premolar (first root)
  8. D3426: apicoectomy - (each additional root)
  9. D4230: anatomical crown exposure - four or more contiguous teeth or bounded tooth spaces per quadrant
  10. D4231: anatomical crown exposure – one to three teeth or bounded tooth spaces per quadrant
  11. D4355: full mouth debridement to enable a comprehensive evaluation and diagnosis on a subsequent visit
  12. D6081: scaling and debridement in the presence of inflammation or mucositis of a single implant, including cleaning of the implant surfaces, without flap entry and closure
  13. D7111: extraction, coronal remnants – primary tooth
  14. D7980: surgical sialolithotomy
  15. D9223: deep sedation/general anesthesia – each subsequent 15 minute increment
  16. D9243: intravenous moderate (conscious) sedation/analgesia – each subsequent 15 minute increment

CDT 2017 code deletions:

  1. D5510: repair broken complete denture base
  2. D5610: repair resin denture base
  3. D5620: repair case framework

When coding, a good rule of thumb is to code for what you have done, not what is covered under the patient’s benefit plan.

If you can’t find a code to describe a procedure, use the appropriate unspecified procedure, by report code, commonly known as the 999 code, e.g., D4999 unspecified periodontics procedure, by report code, but do not forget to include the supporting narrative describing the service provided.

Copies of the CDT 2018 are available for purchase through the American Dental Association at adacatalog.org. It is recommended that all dental offices have a current copy to assist with proper claim billing.



Related Items

Have you ever had one of those moments when you received a decision from a dental benefit plan and thought, “There ought to be a law?” Well, there isn’t a law, in many cases. All health plans must meet requirements as determined by the state agencies that regulate, license and certify them. However, the issues that matter most to providers as well as patients — what is included in the plan’s scope of benefits, for example — are not governed by state laws or regulations.

CDA Practice Support occasionally hears a complaint from dental offices that a plan granted a preauthorization for treatment and then denied payment when the claim was submitted. Digging a little deeper into these complaints, there may be some confusion between what constitutes a “preauthorization” and what is a “predetermination” or pre-estimate of benefits.

Topics
Top