Given the nature of our current global circumstance concerning COVID-19, in addition to dental technologies advances and ever-evolving dental procedures, there is now an updated version of the American Dental Association’s code on dental procedures and nomenclature. Following two ADA Code Maintenance Committee meetings held in March and April of last year, Current Dental Terminology (CDT) changes were implemented to place best interests on behalf of those in the dental profession, their patients, and third-party payers. CDT codes are the only HIPAA-recognized dentistry code set and are required when electronic health care transactions occur. As well, when the ADA alters the codes, carriers must adopt said updates. It’s important for dental practices to stay up-to-date, informed, and well-versed in CDT code changes.
What Has Changed With CDT 2021
- 28 new codes
- 7 revised codes
- 4 deleted codes
- 22 editorial changes (actions that clarify without changing the CDT Code entry procedure’s extent or purpose).
New dental codes for 2021 provide greater specificity for accurate patient record-keeping and to make claim processing simpler. Note that a new or revised code does not dictate reimbursement from insurance providers. In addition, while codes may be recognized, they may not at all be reimbursed. In essence, codes are provided in numerical terms and help articulate the services between providers and insurance companies.
In short, CDT 2021 contains new codes for dental procedures related to:
- Testing to identify patients who may potentially be infected with the coronavirus
- Counseling for the control and prevention of negative impacts on oral, behavioral, and systemic health deriving from high-risk substance use, including vaping
- Caries prevention medicament application
- Teledentistry-derived image captures performed by a licensed practitioner to forward to another dentist for interpretation
Update Your Billing System Each Year to Reflect Code Updates
Updating your practice’s billing system each year to reflect CDT code changes will help clarify treatment for team members, patients, and third-party payers. Doing so provides accurate estimates for your patient load and allows for proper reimbursement. Prior to the year’s end, most insurance carriers notify in-network providers of their requirements and reimbursement protocols.
Establish and Execute an Annual Four-Step Protocol
The objective of CDT Code is to attain uniformity, consistency and specificity in accurately documenting treatment in the dental industry. Therefore, establishing and executing a yearly four-step protocol helps to ensure that your practice, billing system, and insurance coordinator all reflect the new CDT updates.
Here is a sample protocol for consideration:
- Remove deleted codes from your billing software.
- Set fees for the newly enlisted codes.
- Contact insurance companies to review processing guidelines for the changes.
- With your staff, cover how CDT updates/impacts may alter chart note records, posting, and communication with patients for procedures offered.
CDT 2021 Code Changes Overview
28 New Codes
- D0604: Antigen testing for a public health-related pathogen, including coronavirus
- D0605: Antibody testing for a public health-related pathogen, including coronavirus
- 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
- D1321: Counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance abuse
- 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
7 Revised Codes
- D1110: Prophylaxis adult – removal of plaque, calculus, and stains from tooth structure and implants
- D1120: Prophylaxis child – removal of plaque, calculus, and stains from tooth structure and implants
- D1557: Removed language that specified the procedure was done by a dentist or practice that did not originally place the appliance
- D1558:Removed language that specified the procedure was done by a dentist or practice that did not originally place the appliance
- D6011: Removed language specific to access to place a healing cap or to enable placement of an abutment
- D6091: Removed language that the procedure applies to the replaceable male or female component of the abutment
- D9971: Defined per tooth specifications
4 Deleted Codes
- D3427: Several new codes replace this code for greater accuracy
- D5994: Replaced with D5995 and D5996
- D6052: Replaced with D6192
- D7960: Replaced with D7961 and D7962