Updated: Apr 7, 2021
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
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
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.