One thing that stays constant is change—and there is no exception to this rule when it comes to CDT codes! The ADA’s code maintenance Committee (CMC) approved changes for 2019 based on the best interests of the profession, patients, and payers.
- 15 new codes
- 4 deleted codes
- 5 revised codes
It is important to remember a new or revised code does not dictate reimbursement from insurance providers. In fact, codes may be recognized but not reimbursed at all. Consider it a language of sorts that providers and insurance companies understand; it helps communicate the services provided in numerical terms.
Updating your system annually with code revisions:
- Helps clarify treatment for team members, patients, and third party payers
- Provides accurate estimates for your patient base
- Enables proper reimbursement from third-party payers
Most carriers notified in-network providers as to their requirements and reimbursement protocols prior to the end of 2018. We encourage you to follow a two-part protocol annually:
- Reach out to insurance companies you deal with on a regular basis to prepare for changes that occur to CDT definitions on January 1 of each year.
- Facilitate a team meeting to discuss CDT changes and how their impact may shift chart note records, posting, and patient communication for the procedures you offer.
- For 2019, the most impactful changes are the addition of a blood glucose test to reflect the role overall health has in maintaining oral health and a code requested by the American Association of Oral and Maxillofacial Surgeons for a sustained release therapeutic infiltrated drug to reduce the need for narcotic pain medications.
15 New Codes
|D0412||Blood Glucose Level Test—using a glucose meter|
|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 case – metal—maxillary|
|D5283||Removable unilateral partial denture—one piece case – metal—mandibular|
|D5876||Add metal substructure to acrylic full denture (per arch)|
|D9130||TMD—non-invasive physical therapies|
|D9613||Infiltration of sustained release therapeutic drug|
|D9944||Occlusal guard—hard appliance, full arch|
|D9945||Occlusal guard—soft appliance, full arch|
|D9946||Occlusal guard—hard appliance, partial arch|
|D9961||Duplicate/copy patient’s records|
|D9990||Certified translation or sign-language services—per visit|
4 Deleted Codes
|D1515||Space Maintainer—fixed, bilateral|
|D1525||Space Maintainer—removable, bilateral|
|D5281||Removable unilateral partial denture|
|D9940||Occlusal Guard, by report|
5 Revised Codes
|D5211||Maxillary partial denture—resin base (including
|D5212||Mandibular partial denture—resin base (including
|D5630||Repair or replace broken
|D7283||Placement of device to facilitate eruption of impacted tooth
Placement of an
|D9219||Evaluation for moderate sedation, deep sedation or general anesthesia.|
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Learn more, visit the Practice Support Team page, call 1.800.665.5323 or email us at PracticeSupportTeam@BurkhartDental.com
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