Verifying Benefits and Billing for Dental Desensitizing Treatments

Hello, this is Amber Darst, Solutions Manager for Managed Outsource Solutions and I’ll be discussing the codes for dental desensitizing procedures and how to bill and properly check benefit coverage for these specific codes.

Emergency dental visits with patients experiencing pain or sensitivity often times ends in the diagnosis of severe dental caries and even sometimes an infection of the root is found to be the culprit, resulting in an extraction or root canal therapy. But, what about the minor sensitivities? Did you know there’s a less invasive treatment option for those who are experiencing pain and sensitivity without tooth decay? Desensitizing medicament or resin can be remarkably helpful for these instances.

00:55 CDT Codes to Report Dental Desensitizing Procedures

But, how do you know which CDT codes to bill for and when? Let’s take a look at the 2 codes for reporting this procedure.

01:06 D9910 Application of Desensitizing Medicament

This code is used for the topical application of fluoride or other desensitizing medicament applied to the root surface. This code can only be billed once on a per visit basis and involves one or more call quadrants. Also, in the remarks section of the ADA claim form, the type of medicament used should be noted.

01:40 D9911 Application of Desensitizing Resin

And then for

D9911 Application of desensitizing resin

This code, unlike the previous one, is reported on a “per tooth” basis for the application of adhesive resins and/or glass ionomer restorations to a caries-free root surface to treat sensitivity due to exposed dentin. It is not used to report liners or bases of restorations, which are included in the CDT- 4 codes for these particular procedures.

02:15 Importance of Insurance Verification

Now, some insurance policies do not consider either of these codes to be covered services. So completing a thorough insurance verification for each of your patients before their date of service will allow you to check on these codes and ensure that they are covered before the patient is treated. Collecting money upfront for any uncovered services helps keep your accounts receivable reports in clean shape and the revenue flowing smoothly.

I hope this helps, but always remember that documentation and a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed. And that’s all on this.

Thanks for listening in.