Every year, ADCA encourages all coders to prepare for dental code additions, revisions and deletions. The ADA has released the CDT 2019 with 15 additions, five revisions and four deletions that are now in effect.
It is recommended that all dental offices have a current copy of the CDT to assist with proper claim billing. While dental plans are required to recognize new and current CDT codes, they are not required to pay for or provide benefits for the new or revised codes. Dentists should review each dental plan’s payment and processing guidelines to determine whether benefits will be payable. Typically, plans will start sending updates about policy changes for the new year during the fourth quarter. Some offices have already contacted CDA Practice Support inquiring about the notices they have received from dental benefit plans.
New CDT 2019 procedure codes:
- D0412 blood glucose level test – in-office using a glucose meter. This procedure provides an immediate finding of a patient’s blood glucose level at the time of sample collection for the point-of-service analysis.
- D1516 space maintainer – fixed – bilateral, maxillary
- D1517 space maintainer – fixed – bilateral, mandibular
- D1526 space maintainer – removable – bilateral, maxillary
- D1527 space maintainer – removable – bilateral, mandibular
- D5282 removable unilateral partial denture – one-piece cast metal (including clasps and teeth), maxillary
- D5283 removable unilateral partial denture – one-piece cast metal (including clasps and teeth), mandibular
- D5876 add metal substructure to acrylic full denture (per arch)
- D9130 temporomandibular joint dysfunction – noninvasive physical therapies. Therapy including but not limited to massage, diathermy, ultrasound or cold application to provide relief from muscle spasms, inflammation or pain, intending to improve freedom of motion and joint function. This should be reported on a per session basis.
- D9613 infiltration of sustained release therapeutic drug – single or multiple sites. Infiltration of a sustained-release pharmacologic agent for long-acting surgical-site pain control. Not for local anesthesia purposes.
- D9944 occlusal guard – hard appliance, full arch. Removable dental appliance designed to minimize the effects of bruxism or other occlusal factors. Not to be reported for any type of sleep apnea, snoring or TMD appliances.
- D9945 occlusal guard – soft appliance, full arch. Removable dental appliance designed to minimize the effects of bruxism or other occlusal factors. Not to be reported for any type of sleep apnea, snoring or TMD appliances.
- D9946 occlusal guard – hard appliance, partial arch. Removable dental appliance designed to minimize the effects of bruxism or other occlusal factors. Provides only partial occlusal coverage such as anterior deprogrammer. Not to be reported for any type of sleep apnea, snoring or TMD appliances.
- D9961 duplicate/copy patient’s records
- D9990 certified translation or sign-language services – per visit
CDT 2019 Revisions:
- D5211 maxillary partial denture – resin base (including any conventional clasps retentive/clasping materials, rests and teeth). Includes acrylic resin base denture with resin or wrought wire clasps.
- D5212 mandibular partial denture – resin base (including any conventional clasps retentive/clasping materials, rests and teeth). Includes acrylic resin base denture with resin or wrought wire clasps.
- D5630 repair or replace broken clasp retentive/clasping materials – per tooth
- D7283 placement of device to facilitate eruption of impacted tooth. Placement of an orthodontic bracket, band or other device attachment on an unerupted tooth, after its exposure, to aid in its eruption. Report the surgical exposure separately using D7280.
- D9219 evaluation for moderate sedation, deep sedation or general anesthesia
CDT 2019 Deletions:
- D1515 space maintainer – fixed – bilateral
- D1525 space maintainer – removable – bilateral
- D5281 removable unilateral partial denture – one-piece cast metal (including clasps and teeth)
- D9940 occlusal guard, by report. Removable dental appliances, which are designed to minimize the effects of bruxism (grinding) and other occlusal factors.
When coding, remember to code for what you have done, not what is covered under the patient’s benefit plan. If you can’t find a code to describe a procedure, use the appropriate unspecified procedure, by report code, commonly known as the 999 code, e.g., D4999 unspecified periodontics procedure, by report, but do not forget to include the supporting narrative describing the service provided.