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Sarah Beth Herman- Sarah Beth Herman
2022 New CDT Codes, Changes, Deletions and pandemic related codes you need to see!!
IT'S HERE!!!
5 Minutes of reading and a year's worth of knowledge to help grow your dental office!
(Well some of this has been out since November 16th, 2021 but we knew more changes were coming so we are launching this in December 2021 with the newest released information on CDT codes!)
Please be sure not to submit claims for the new codes with dates of service prior to January 1, 2022, and do not submit claims for the deleted codes for dates of service on or after January 1, 2022.
We have broken this down to simplify the new changes for 2022 that your dental office needs to prepare for. Effective January 1st, 2022 CDT has 16 additions, 14 revisions, and 6 deletions, including eight codes adopted in March of 2021 for vaccine administration and molecular testing for a public health-related pathogen. In other words, we have pandemic-related codes listed below. Please use the drop-down option for additional descriptions and notes.
D3911 Intraorifice barrier
Not to be used as a final restoration. Also in 2022, dentists performing endodontic therapies may benefit from a new diagnostic code relating to the use of an intraorifice barrier, not to be used as a final restoration. This new code was requested by the American Association of Endodontists on the basis that the intraorifice barrier is distinct from endodontic procedures that stop at the gutta percha and that the intraorifice barrier is usually done to ensure endodontic success when there may be a delay in restoring the tooth.
D3921 Decoronation or submergence of an erupted tooth
Intentional removal of a coronal tooth structure for preservation of the root and surrounding bone.
D4322 Splint-intra-coronal; natural teeth or prosthetic crowns
Additional procedure that physically links individual teeth or prosthetic crowns to provide stabilization and additional strength.
D4323 Splint – extra-coronal; natural teeth or prosthetic crowns
Additional procedure that physically links individual teeth or prosthetic crowns to provide stabilization and additional strength.
D5227 Immediate maxillary partial denture - flexible base (including any clasps, rests and teeth)
D5228 Immediate mandibular partial denture - flexible base (including any clasps, rests and teeth)
D5725 Rebase hybrid prosthesis
Replacing the base material connected to the framework.
D5765 Soft liner for complete or partial removable denture – indirect
A discrete procedure provided when the dentist determines placement of the soft liner is clinically indicated.
D6198 Remove interim implant component
Removal of implant component (e.g., interim abutment; provisional implant crown) originally placed for a specific clinical purpose and period of time determined by the dentist.
D7298 Removal of temporary anchorage device [screw retained plate], requiring flap
D7299 Removal of temporary anchorage device, requiring flap
D7300 Removal of temporary anchorage device without flap
D9912 Pre-visit patient screening
Capture and documentation of a patient’s health status prior to or on the scheduled date of service to evaluate risk of infectious disease transmission if the patient is to be treated within the dental practice.
D9947 Custom sleep apnea appliance fabrication and placement
D9948 Adjustment of custom sleep apnea appliance
D9949 Repair of custom sleep apnea appliance
Orthodontic Code Changes
Let's talk about deletions regarding Orthodontics. The Orthodontic Code Action Requests have been approved as noted below.
Deletion of the Interceptive Orthodontic Treatment subcategory nomenclature, descriptor, and codes D8050 and D8060
Revision of the Limited Orthodontic Treatment descriptor
The AAO has stated that new language for Limited Orthodontic Treatment will be written as follows:
Orthodontic treatment utilizing any therapeutic modality with a limited objective or scale of treatment. Treatment may occur in any stage of dental development or dentition.
The objective may be limited by:
not involving the entire dentition.
not attempting to address the full scope of the existing or developing orthodontic problem.
mitigating an aspect of a greater malocclusion (i.e., crossbite, overjet, overbite, arch length, anterior alignment, one phase of multi-phase treatment, treatment prior to the permanent dentition, etc.).
a decision to defer or forego comprehensive treatment.
D8010: limited orthodontic treatment of the primary dentition
D8020: limited orthodontic treatment of the transitional dentition
D8030: limited orthodontic treatment of the adolescent dentition
D8040: limited orthodontic treatment of the adult dentition
3. Deletion of D8690 “orthodontic treatment (alternative billing to a contract fee).”
Included in CDT 2022 are eight COVID-19 codes relevant to vaccine administration that were approved in CDT 2021. The CDT Code already has entries for documenting antigen and antibody testing. The new pandemic related codes are:
D1701: Pfizer-BioNTech COVID-19 vaccine administration – first dose
(SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 1)
D1702: Pfizer-BioNTech COVID-19 vaccine administration – second dose
(SARSCOV2 COVID-19 VAC mRNA 30mcg/0.3mL IM DOSE 2)
D1703: Moderna COVID-19 vaccine administration – first dose
(SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 1)
D1704: Moderna COVID-19 vaccine administration – second dose
(SARSCOV2 COVID-19 VAC mRNA 100mcg/0.5mL IM DOSE 2)
D1705: AstraZeneca COVID-19 vaccine administration – first dose
(SARSCOV2 COVID-19 VAC rS-ChAdOx1 5x1010 VP/.5mL IM DOSE 1)
D1706: AstraZeneca COVID-19 vaccine administration – second dose
(SARSCOV2 COVID-19 VAC rS-ChAdOx1 5x1010 VP/.5mL IM DOSE 2)
D1707: Janssen (Johnson & Johnson) COVID-19 vaccine administration
(SARSCOV2 COVID-19 VAC Ad26 5x1010 VP/.5mL IM SINGLE DOSE)
D0604 antigen testing for a public health-related pathogen, including coronavirus.
D0605 antibody testing for a public health-related pathogen, including coronavirus.
Note: The use of codes related to the AstraZeneca vaccine are contingent upon that vaccine being granted Emergency Use Authorization by the U.S. Food and Drug Administration (FDA). The Ontario Academy of General Dentistry notes that dentists who seek to provide their patients with either COVID-19 testing or vaccination services may want to consider cross-coding for those procedures under patients’ medical insurance.
A notable change for CDT 2022 is the revision to the descriptors for various codes, allowing for broader applicable scenarios when treating patients.
D0120 Periodic oral evaluation – established patient
An evaluation performed on a patient of record to determine any changes in the patient’s dental and medical health status since a previous comprehensive or periodic evaluation. This includes an oral cancer evaluation, periodontal screening where indicated and may require interpretation of information acquired through additional diagnostic procedures. The findings are discussed with the patient. Report additional diagnostic procedures separately.
D0180 Comprehensive periodontal evaluation – new or established patient
This procedure is indicated for patients showing signs or symptoms of periodontal disease and for patients with risk factors such as smoking or diabetes. It includes evaluation of periodontal conditions, probing and charting, an evaluation for oral cancer, the evaluation and recording of the patient’s dental and medical history, and general health assessment. It may include the evaluation and recording of dental caries, missing or unerupted teeth, restorations, and occlusal relationships and oral cancer evaluation.
D1354 Application of caries arresting medicament – per tooth
Conservative treatment of an active, non-symptomatic carious lesion by topical application of a caries arresting or inhibiting medicament and without mechanical removal of sound tooth structure.
D2799 Interim crown – further treatment or completion of diagnosis necessary prior to
final impression
Not to be used as a temporary crown for a routine prosthetic restoration.
D2971 Additional procedures to customize a crown to fit under an existing partial denture framework
This procedure is in addition to the separate crown procedure documented with its own code.
D4265 Biologic materials to aid in soft and osseous tissue regeneration, per site
Biologic materials may be used alone or with other regenerative substrates such as bone and barrier membranes, depending upon their formulation and the presentation of the periodontal defect. This procedure does not include surgical entry and closure, wound debridement, osseous contouring, or the placement of graft materials and/or barrier membranes. Other separate procedures may be required concurrent to D4265 and should be reported using their own unique codes.
D4276 Combined connective tissue and pedicle graft, per tooth
Advanced gingival recession often cannot be corrected with a single procedure. Combined tissue grafting procedures are needed to achieve the desired outcome.
D5862 Precision attachment, by report
Each pair of components is one precision attachment. Describe the type of attachment used.
D5867 Replacement of replaceable part of semi-precision or precision attachment, per attachment
D6012 Surgical placement of interim implant body for transitional prosthesis: endosteal implant
D6051 Interim implant abutment placement
A healing cap is not an interim abutment
D6085 Interim implant crown
Placed when a period of healing is necessary prior to fabrication and placement of the definitive prosthesis.
D6091 Replacement of replaceable part of semi-precision or precision attachment of implant/abutment supported prosthesis, per attachment
D6100 Surgical removal of implant body
D6253 Interim pontic - further treatment or completion of diagnosis necessary prior to
final impression
Not to be used as a temporary pontic for a routine prosthetic restoration.
D6793 Interim retainer crown - further treatment or completion of diagnosis necessary prior to final impression
Not to be used as a temporary retainer crown for a routine prosthetic restoration.
D6950 Precision attachment
A pair of components constitutes one precision attachment that is separate from the prosthesis.
D7292 Placement of temporary anchorage device [screw retained plate] requiring flap.
D7293 Placement of temporary anchorage device requiring flap.
D7294 Placement of temporary anchorage device without flap
D9613 Infiltration of sustained release therapeutic drug
Infiltration of a sustained release pharmacologic agent for long acting surgical site pain control. Not for local anesthesia purposes.
D9997 Dental case management – patients with special health care needs
Special treatment considerations for patients/individuals with physical, medical, developmental, or cognitive conditions resulting in substantial functional limitations or incapacitation, which require that modifications be made to delivery of treatment to provide customized or comprehensive oral health care services.
That's right. We waited to post these announcements until you could see first-hand the changes many insurance companies are changing for 2022. Please update the verification sheet you use when obtaining patient dental insurance eligibility.
One thing to note is that not ALL insurances will be up to the standards listed below but if they are, you need to be prepared. Coding and aligning with the requirements outlined here will ensure you are paid promptly.
The following oral evaluations performed without an intent to provide dental services to meet the patient’s needs will be processed as a D0190 (screening of a patient):
D0120 Periodic oral evaluation – established patient
D0150 Comprehensive oral evaluation – new or established patient
D0180 Comprehensive periodontal evaluation – new or established patient
Oral evaluations are only a benefit when the elements included in the descriptor are completed.
D0140 limited oral evaluation – problem focused
The following codes will be changing with most insurances from non-covered to a covered code under Diagnostic & Preventive once every 12 months (in most cases with insurance companies):
D0190 Screening of a patient
When reported in conjunction with an evaluation/screening (D0120, D0140, D0145, D0150, D0160, D0170, D0171, D0180, D0190 and D9310) the fees for D0190 are NOT BILLABLE TO THE PATIENT as integral to the evaluation by the same dentist/dental office on the same date of service
D0191 Assessment of a patient
When reported in conjunction with an evaluation/screening (D0120, D0140, D0145, D0150, D0160, D0170, D0171, D0180, D0190 and D9310) the fees for D0190 are NOT BILLABLE TO THE PATIENT as integral to the evaluation by the same dentist/dental office on the same date of service
The age limitation for individuals ages 6 and older, will be removed with most insurances for:
D0330 Panoramic radiographic image
Benefits for restorations placed within two (2) months may be denied for:
D1354 Application of caries arresting medicament
When D3473, D3501-D3503 are performed on the same tooth by the same dentist/dental office, the fees for scaling and root planning may not be BILLABLE TO THE PATIENT for:
D4341 Periodontal scaling and root planning - four or more teeth
D4342 Periodontal scaling and root planning – one to three teeth
The fee for D7410 may not be BILLABLE TO THE PATIENT as included in the fee for another surgery in the same area of the mouth on the same day by the same dentist/dental office
D7410 Excision of benign lesion up to 1.25 cm
The fee for D7411 may not be BILLABLE TO THE PATIENT as included in the fee for another surgery in the same area of the mouth on the same day by the same dentist/dental office.
D7411 Excision of benign lesion greater than 1.25 cm
The fee for D7415 may not be BILLABLE TO THE PATIENT as included in the fee for another surgery in the same area of the mouth on the same day by the same dentist/dental office
D7415 Excision of malignant lesion, complicated
The fee for D7450 may not be NOT BILLABLE TO THE PATIENT as included in the fee for another surgery in the same area of the mouth on the same day by the same dentist/dental office
D7450 Removal of benign odotogenic cyst or tumor – lesion diameter up to 1.25 cm
The fee for D7451 may not be BILLABLE TO THE PATIENT as included in the fee for another surgery in the same area of the mouth on the same day by the same dentist/dental office.
D7451 Removal of benign odotogenic cyst or tumor – lesion diameter up to 1.25 cm
When covered, benefit D9613 once per date of service when submitted with extractions (D7220-D7241), and any additional D9613 submitted on the same date of service may not be BILLABLE TO THE PATIENT.
D9613 Infiltration of sustained release therapeutic drug, per quadrant
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