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CDT Part 2 If your insurance coordinator isn’t already up-to-date on and using the American Dental Association’s Current Dental Terminology 2007/2008 code revisions, it’s time to make a change—unless, of course, you enjoy dealing with the major insurance-related headaches that are sure to come if old habits prevail. The ADA updates the CDT manual every two years, and revisions to code nomenclature and descriptors should not be taken lightly. Chapter two, “Changes to the Code,” lists all the revisions in one place. The deleted verbiage appears in red and is crossed through, while the revised wording is blue. Don’t have the manual handy? Look no further. Once you read and study this article, you’ll be equipped with all the knowledge you need to properly code using the latest revisions. Clinical Oral Evaluations – Three revised codes • D0120 – Used for periodic oral evaluations. The words “an oral cancer evaluation,” indicating this should be part of an oral evaluation, were added. However, D0120 does not cover an oral cancer diagnostic procedure—use code D0431 for that. The words “where indicated” were applied to oral cancer screening and periodontal screening, meaning dentists can do these when they deem necessary. • D0150 – This code is for comprehensive oral evaluations. The word “typically,” appearing twice in the old version, was removed. “Would” was deleted from the second paragraph. Deleting these words indicates that no other code can be used for a comprehensive exam. This code covers comprehensive oral exams for new patients, established patients (who have not been seen within the last three years), or established patients with a significant change in health status (by report). The words “evaluation and recording of existing prostheses” were added to the descriptor. The revision appears to not require periodontal charting, indicated by the words “periodontal screening and/or charting,” which better allows the periodontist to use code D0180 because the referring dentist can use D0150. • D0180 – Used for comprehensive periodontal exams. “Screening,” the last word in the old version, was replaced by “oral cancer evaluation.” Oral pathology laboratory - four revised codes • D0472, D0473 and D0474 – “To be used in reporting architecturally intact tissue obtained by invasive means” was added to the descriptors of all three codes, which deal with accession of tissue. • D0480 – This code is used for the accession of exfoliative cytologic smears, microscopic examination and the preparation and transmission of written report. “Processing and interpretation” was deleted from the first sentence of the nomenclature and “including the” was deleted from the second sentence. The code now reads: “Accession of exfoliative cytologic smears, microscopic examination, preparation and transmission of written report.” The descriptor now reads, “To be used in reporting disaggregated, non-transepithelial cell cytology sample via mild scraping of the oral mucosa.” Only the pathology lab should use this code.
Restorative: two revised codes • D2952 – Reports post and core in addition to crown, indirectly fabricated. “Cast” was removed from the nomenclature and the descriptor, replaced with “indirectly fabricated.” The new nomenclature states: “Post and core in addition to crown, indirectly fabricated.” “Is separate from crown” was deleted from the descriptor, replaced with “Post and core are custom fabricated as a single unit.” These revisions provide for any custom fabrication used. • D2953 – Used for each additional, indirectly fabricated post on the same tooth. Again, “cast” was removed and replaced with “indirectly fabricated” for the same reason as stated above. CONTINUED ON NEXT PAGE
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