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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. ...
The American Dental Association (ADA) has released its Code on Dental Procedures and Nomenclature for 2021 (CDT 2021) Please use CDT 2021 codes when submitting claims to any dental/medical insurance for services you perform on or after January 1, 2021. If you are resubmitting claims where your...
The patient owns their records and therefore is entitled to a copy (not original) whether they have a balance on their account or not. Most practices have digital radiographs, photos, and notes, so it isn't an access issue. Providing a copy to the patient or...
*From the American Dental Association: The committee added the following procedure codes to CDT 2021: *• D0604 — antigen testing for a public health-related pathogen, including coronavirus. Definition from the Merriam Webster dictionary: Antigen is any substance (such as an immunogen or a hapten) foreign to the body that...
Dental plans are required to recognize current CDT codes, it is important to understand that they are not required to provide benefits for the new or revised codes. Yearly, dentists should review each dental plan’s payment and processing policies to discover whether benefits will be...
Coding Tip: D0170 Limited, Problem Focused (Established Patient, not a post-operative visit) "Code what you do" is the mantra for filing of dental claims; however confusion over which codes to use is where we sometimes lose our way D0170 is used when the dentist is "assessing the...
D0431 is a visual cancer detection screening test, not to be confused with a biopsy, which is a different code (possibly D7288 brush biopsy which harvests transepithelial cells). If the visual oral cancer examination reveals mucosal abnormalities, the dentist may consider the biopsy or a...
“Take Back Codes” Insurance companies have the right to reduce a benefit(by taking the money back) for a service if the related service has already been paid on another submittal. For instance, the patient came in for a fractured tooth and a protective resin was...
D4346 Scaling in Presence of Generalized Moderate or Severe Gingival Inflammation--Full Mouth, after Oral Evaluation Never use this code as a “difficult prophy.” D4346 does not relate to the amount of time or effort to complete the procedure. D4346 is a therapeutic procedure that can be...
D4249 Crown Lengthening-Hard tissue is performed on a tooth with healthy periodontium (no perio disease). The procedure, to be considered a covered benefit, must follow the code descriptor carefully within the clinical documentation. Such as a “full-thickness flap reflected, and bone removed to expose more...
