CDT PART 1
Code changes: What you need to know
HAVE THESE NEW CODES ON HAND TO AVOID CLAIM DENIAL HEADACHES
BY MARIANNE HARPER
Editor’s note: This is the first of a three-part series that breaks down 2007’s insurance code changes. Check out next month’s article for everything you need to know about code revisions. The final installment focuses on the ADA dental claim form revision.
FOR PART 2 - CLICK HERE
FOR PART 3 - CLICK HERE
If incorrect coding is flooding your practice with claim denials, it may just be that you’re not up to par with the latest codes. The American Dental Association publishes its coding manual every two years, complete with additions, deletions and revisions to the previous issue. This year’s version, Current Dental Terminology 2007/2008, packs a double punch with revisions to the ADA claim form.
The updated manual includes 23 new codes that you need to learn for efficient claim processing and prompt payment. Here you’ll find a review of all the additions and deletions, according to category. Check out Dental Practice Report in August and September for the run down on revisions to the code-set and the dental claim form.
For now, read through the changes carefully, learn them and put them to use.
Diagnostic: Six new procedure codes
- D0145 – Use for oral evaluation of a patient under 3 years old. Includes counseling with primary caregiver.
Radiographic: Four code-set additions - D0273 - Created to report three bitewings taken on one service date.
- D0360 –Use for cone beam ct for craniofacial data capture.
- D0362 – Use for two-dimensional image reconstruction that uses existing data. Includes multiple images.
- D0363 –Only differs from D0362 because it’s used for 3D image reconstruction.
Oral pathology laboratory: One new code - D0486 - Created to report the accession of a brush biopsy sample of transepithelial, disaggregated cells. Also includes microscopic examination and written report preparation and transmission.
Preventive codes: Two new procedures
- D1206 - Reports topical fluoride varnish application for moderate to high caries risk patients.
- D0155 - Use to report fixed space maintainer removal. The dentist who placed the appliance or another dentist can use this code.
Restorative: One new code
- D2970 –Use when a temporary crown is fitted over a fractured tooth. This temporary crown is usually a preformed artificial crown. Keep in mind this is not the code for a temporary crown used during crown prep appointments.
Periodontal: Two new codes
*Both cover the same procedure, anatomical crown exposure, but differ in the number of teeth involved.
- D4230 – Use for procedure in an otherwise periodontally healthy area that creates an anatomically correct relationship by removing enlarged gingival tissue and supporting bone. The quadrant must contain four or more contiguous teeth.
- D4231 – Use for the same procedure as D4230, but only when the quadrant has one to three teeth.
- Implants: Four new codes
- D6012 – Created for the surgical placement of an interim implant body for transitional prosthesis for endosteal implants. Removal is included.
- D6091 –Provides for the replacement of the male or female component of a semi-precision or precision attachment of an implant/abutment supported prosthesis, per attachment.
- D6092 and D6093 –Created to report the re-cementation of an implant/abutment supported crown (D6092) or of an implant/abutment supported fixed partial denture (D6093)
Oral and Maxillofacial Surgical: Five procedure codes
*The first three deal with temporary anchorage devices.
- D7292 –Use when a surgical flap is created and a temporary skeletal anchorage device (a screw retained plate) is attached to the bone by screws. Includes device removal.
- D7293 –Use for the surgical placement of a skeletal anchorage device when it is not a screw retained plate. Includes device removal.
- D7294 –Reports temporary anchorage device placement, but without the surgical flap.
- D7951 – Use to report the augmentation of the sinus cavity to increase alveolar height. Includes obtaining bone or bone substitutes. Does not include barrier membrane placement.
- D7998 –Reports fixation appliance placement. Do not use for fractures.
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Orthodontic: One addition
- D8693 – Use to report the re-bonding, re-cementation and/or repair of fixed retainers.Adjunctive
General Services: Two additions
- D9120 – Reports sectioning a fixed partial denture for one or more connections between abutments and/or pontics when a portion of the fixed partial denture is to remain intact after the sectioning and extraction or other treatment. Includes recontouring and polishing of the retained portions.
- D9612 –Use to report the necessary administration of at least two or more different therapeutic parenteral drugs such as antibiotics, steroids, anti-inflammatory drugs, or other therapeutic medications but not the administration of sedatives, anesthetics, or reversal agents. Do not use this code the same day as D9610 (single administration of a therapeutic parenteral drug). Use one or the other depending on the number of drugs administered.
With these additions also come deletions. This year, three procedure codes were eliminated from the CDT 2007/2008 manual.
Deleted codes
- D1201 and D1205— These codes were used to combine prophies and fluoride treatments into one code. Coders now must file each separately.
- D6971—Used to report a cast post as part of a fixed partial denture retainer.
Categories with no additions or deletions
- Endodontic
- Removable and fixed prosthodontic and maxillofacial prosthetics
Now that you’re aware of the changes, make sure your insurance coordinator adds these new codes to your practice management software. Study and become familiar with them. It’s a good idea to have your entire staff review the new codes, possibly at a staff meeting, so everyone is familiar with how to code different procedures correctly.
Contact the ADA’s Council on Dental Benefit or me if you have any questions about these changes. The ADA e-mail for coding issues is dentalcode@ada.org. Other excellent sources for insurance information are the “Insurance Solutions Newsletter” at www.dental-ins-solutions.com and Dr. Charles Blair’s manual Coding with Confidence: The ‘Go To’ Guide for CDT 2007/2008.”
Check back next month for a run down of the CDT 2007/2008 code revisions. In the meantime, remember that insurance matters!
American Dental Association, CDT 2007/2008 (Chicago, IL: American Dental Association, 2006) pages 3 through 102
Marianne Harper owns The Art of Practice Management, a dental practice management consulting company. Revenue and collection systems, front-desk systems, dental-medical cross-coding and employment law compliance are her specialties. Marianne is a member of The Academy of Dental Management Consultants, The Professional Management Consultants Association and the Speaking Consulting Network (SCN). She is BOP Certified with Bent Ericksen and Associates, is a published author, and a respected speaker. Visit her Web site at www.artofpracticemanagement.com or through the SCN Web site, www.speakingconsultingnetwork.com. You can also contact Marianne at 252-637-6259, 252-670-0403 or at a.p.m.1@suddenlink.net.
FOR PART 2 - CLICK HERE
FOR PART 3 - CLICK HERE