One thing that stays constant is change – and there is no exception to this rule regarding CDT codes.  

The ADA’s code maintenance committee has released the additions, deletions, and editorial changes that will take effect on January 1, 2024.

Code revisions take place based on the best interests of the profession, patients, and payers and will have a varied impact based on their relevance and code usage for each dentist. For 2024, the updates include:

  • 14 new codes
  • 2 revised codes
  • No deleted codes

Remember that a new or revised code does not dictate reimbursement from insurance providers. Recognized codes may not be reimbursed at all. Consider it a language that providers and insurance companies understand; it helps communicate the services provided numerically.

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 notify in-network providers of their requirements and reimbursement protocols before the end of the year.

We encourage you to follow a two-part protocol annually:

  • Contact insurance companies you are contracted with to review processing guidelines for upcoming changes
  • Facilitate a team meeting where you discuss CDT changes and how their impact may shift chart note records, posting, and patient communication for your offered procedures
  • Set fees for new codes and remove deleted codes from your billing software

While we don’t expect a change in fees for revised codes, finding average fees for new codes is difficult. The National Data Advisory Service (NDAS) and Fair Health Consumer calculate fee averages based on filed insurance claims over time. It takes six months to a year to see averages for new codes. When setting fees for new codes, consider referencing your carrier fee schedules. If they list reimbursement rates for the latest codes, consider a 30-50% increase to the fee listed, as PPO contracts typically require a 30-50% write-off. For the rest of the codes, we recommend setting a price based on the following:

  • Cost of material/lab fees
  • Cost to turn over an operatory (2023 average is $11.88)
  • Hourly compensation for needed clinician(s)
  • 40 – 50% additional for-profit margin

14 New Codes
D0396 3D Printing of a 3D Dental Surface Scan
D1301 Immunization Counseling
D2976 Band Stabilization – Per Tooth
D2989 Excavation of a Tooth Resulting in the Determination of Non-Restorability
D2991 Application of Hydroxyapatite Regeneration Medicament – Per Tooth
D6089 Accessing and Retorquing Loose Implant Screw – per screw
D7284 Excisional Biopsy of Minor Salivary Glands
D7939 Indexing for Osteotomy using Dynamic Robotic Assisted or Dynamic Navigation
D9938 Fabrication of a Custom Removable Clear Plastic Temporary Aesthetic Appliance (“Essix” appliance)
D9939 Placement of a Custom Removable Clear Plastic Temporary Aesthetic Appliance (“Essix appliance)
D9954 Fabrication and Delivery of Oral Appliance Therapy (OAT) Morning Repositioning Device
D9955 Oral Appliance Therapy (OAT) Titration Visit
D9956 Administration of Home Sleep Apnea Test
D9957 Screening for Sleep Related Breathing Disorders

 

2 Revised Codes
D2335 Resin-Based Composite – Four or More Surfaces – Anterior
D5876 Add Metal Substrate to Acrylic Full Denture – Per Arch

 

Reach out to your Burkhart Account Manager or Burkhart’s Practice Support Team with your questions regarding changes in codes, coding strategies to maximize reimbursement, and analyzing managed care participation in your practice.

 

Your success is our success. Please reach out to us anytime.
Learn more, visit the Practice Support Team page, email us at PracticeSupportTeam@BurkhartDental.com, or call 1.800.665.5323.

Burkhart Dental Supply – Practice Support Team

 

 

 

 

Category: Practice Consulting

Back to Articles