Every year, the American Dental Association (ADA) makes changes to CDT codes and many practices outsource dental billing to stay on top of these updates, document patient care provided and submit insurance claims to meet payer guidelines.
Several CDT code changes came into effect on January 1, 2021. These include 28 new CDT codes, 4 code deletions and many description revisions. The new CDT codes include 9 new codes for image capture only. Many of these updates made by the American Dental Association (ADA) reflect the impact of technological advancements in dentistry and also the effect of COVID-19.
- Two New COVID-19 related codes
D0604 – Antigen testing for a public health related pathogen, including coronavirus
D0605 – Antibody testing for a public health related pathogen, including coronavirus
With these codes, dental practices document and bill testing for pathogens such as SARS-CoV-2 which causes COVID-19.
- Image Capture Only Codes
There are 9 new ‘image capture only’ codes in the ‘diagnostic imaging’ subcategory to accommodate evolving techniques for image capture. According to the ADA, the structure and content changes enable unambiguous reporting of radiographic and photographic image capture and interpretation procedures. The new CDT image capture only codes are:
D0701 Panoramic radiographic image – capture only
D0702 2-D cephalometric radiographic image – capture only
D0703 2-D oral-facial photographic image – capture only
D0704 3-D photographic image – capture only
D0705 Extra-oral posterior dental radiographic image – capture only
D0706 Intraoral occlusal radiographic image – capture only
D0707 Intraoral periapical radiographic image – capture only
D0708 Intraoral bitewing radiographic image – capture only
D0709 Intraoral complete series of radiographic images – capture only
Points to Note:
- CDT codes D0701-D0709 for radiographic and photographic image capture can be reported on claims when a dentist refers a patient to a separate facility or another practitioner for imaging only and subsequently gets these images back for interpretation.
- These new codes allow the practitioner who performs the image capture to report the separate work components that comprise piecemeal imaging/interpretation encounters.
- The new image capture only codes also allow payers to more clearly interpret and value claims and provide appropriate reimbursement for these encounters.
- Except for D0709, all image capture only procedures address acquisition of a single image. When more than one type of image is captured on the date of service, the procedure should be reported once and the number of images captured should be reported in the claim’s quantity field.
The new CDT codes D0701-D0709 are expected to improve the teledentistry claim submission process that has increased significantly with the COVID-19 pandemic.
- New code to report substance use and abuse
Dentists can now report substance abuse and counselling using a new code:
D1321 Counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance abuse
One note of the new code states, “Counseling services [that] may include patient education about adverse oral, behavioral, and systemic effects associated with high-risk substance use and administration routes. This includes ingesting, injecting, inhaling and vaping. Substances used in a high-risk manner may include but are not limited to alcohol, opioids, nicotine, cannabis, methamphetamine and other pharmaceuticals or chemicals.”
- Other notable new CDT codes
D1355 Caries preventative medicament application – per tooth
D2928 Prefabricated porcelain/ceramic crown – permanent tooth
D3471 Surgical repair of root resorption – anterior tooth
D3472 Surgical repair of root resorption – premolar tooth
D3473 Surgical repair of root resorption – molar tooth
D3501 Surgical exposure of root surface without apicoectomy or repair of root resorption – anterior
D3502 Surgical exposure of root surface without apicoectomy or repair of root resorption – premolar
D3503 Surgical exposure of root surface without apicoectomy or repair of root resorption – molar
D5995 Periodontal medicament carrier with peripheral seal – lab-made – maxillary arch
D5996 Periodontal medicament carrier with peripheral seal – lab-made – mandibular arch
D6191 Semi-precious abutment – placement
D6192 Semi-precious attachment – placement
D7961 Buccal/labial frenectomy
D7962 Lingual frenectomy
D7993 Surgical placement of craniofacial implant – extraoral
D7994 Surgical placement of zygomatic implant
- Deleted codes
D3427 Periradicular surgery without apicoectomy
D5994 Periodontal medicament carrier with peripheral seal- laboratory processed
D7960 Frenulectomy – also known as frenectomy or frenotomy – separate procedure not incidental to another procedure
- Revised codes
D1110 Prophylaxis – adult Removal of plaque, calculus and stains from tooth structures and implants in the permanent and transitional dentition. It is intended to control local irritational factors.
D1120 Prophylaxis – child Removal of plaque, calculus and stains from tooth structures and implants in the primary and transitional dentition. It is intended to control local irritational factors.
D1557 Removal of fixed bilateral space maintainer – maxillary
D1558 Removal of fixed bilateral space maintainer – mandibular
D6011 Surgical access to an implant body (second stage implant surgery)
D6091 Replacement of replaceable part of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis, per attachment.
D9971 Ondontoplasty – per tooth
Keeping pace with the changes in codes and billing rules can be a challenge as you provide patients with the treatment they need. The best option is to rely on dental billing services to maximize reimbursement and minimize denials. The expert team in a dental billing company will be knowledgeable about the appropriate codes to report as well as payer contract language and rules, which is critical to ensure error-free claim submission.
Amber Darst is our Solutions Manager in the Healthcare Division, Practice and RCM. With a rich background in dental services, her expertise ranges from insurance coordination to office management.