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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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