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Roy

Roy Shelburne

Director of Insurance Administration & Compliance

2021 CDT Codes: Which Radiograph Code Do I Use?

CDT code changes adopted by the American Dental Association’s Code Maintenance Committee become effective on January 1st each year.  Dental teams are made aware of the changes when the new reference materials become available, usually around the end of July or the first of August.  Many wait to see if there are any new codes they may utilize to help describe the services provided and perhaps increase the practice’s reimbursement.  

This year, there were a number of code changes that caught the attention of Office Managers, business team members, and doctors. These new codes were in the 700’s and were adopted to describe radiographic “image capture only”.  Many thought these additions to the CDT code set for 2021 meant that they could now code and bill for both the capture and for the interpretation of those radiographic images individually.  Ultimately, because of these additions, there are those who thought both capture and interpretations of the various 2-D radiographic images could be submitted to the patient’s plan for reimbursement.  Alas, this is not the case except in very rare instances.  

The intent of the code committee was to fill a need for a gap in the CDT.  Certainly there was a gap, but not to describe the vast majority of cases where the practice takes the radiograph and the treating dentist interpreted the radiographic image.  The gap occurred when, in the rare instance, a dentist authorized the capture of the image and that image is forwarded to a radiologist who would interpret the captured image — to “read” the image as it is often referred.  

The old coding for our many intraoral and extra oral images that have existed for years have not changed.  The distinction and limited applicability of these new codes is established by the descriptor of the interpretation code D0391.  “D0391 Interpretation and Report Only:  Interpretation and Report by a Practitioner not associated with the Image Capture; interpretation of diagnostic image by a practitioner not associated with capture of an image, including report”, makes it clear that the entity taking the image and the entity interpreting the image “not associated with the image capture”.  This means that the doctor authorizing the capture of the image cannot be associated with the individual providing the interpretation.  The individual interpreting the image would be employed by another entity, not associated in any way with the individual or group that captured the image.  

The bottom line? The new capture only 700 codes are to be used when the image is “sent out of house” to be interpreted.  So, continue to use the existing radiographic image codes as they always have been used unless the image is captured and forwarded away to be interpreted. Nothing has changed in the coding for radiographic images unless the image is sent to another entity for interpretation.

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