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
- 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
|3D Printing of a 3D Dental Surface Scan
|Band Stabilization – Per Tooth
|Excavation of a Tooth Resulting in the Determination of Non-Restorability
|Application of Hydroxyapatite Regeneration Medicament – Per Tooth
|Accessing and Retorquing Loose Implant Screw – per screw
|Excisional Biopsy of Minor Salivary Glands
|Indexing for Osteotomy using Dynamic Robotic Assisted or Dynamic Navigation
|Fabrication of a Custom Removable Clear Plastic Temporary Aesthetic Appliance (“Essix” appliance)
|Placement of a Custom Removable Clear Plastic Temporary Aesthetic Appliance (“Essix appliance)
|Fabrication and Delivery of Oral Appliance Therapy (OAT) Morning Repositioning Device
|Oral Appliance Therapy (OAT) Titration Visit
|Administration of Home Sleep Apnea Test
|Screening for Sleep Related Breathing Disorders
2 Revised Codes
|Resin-Based Composite – Four or More Surfaces – Anterior
|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.
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