Dental Codes: What You Need to Know

The Do’s and Don’ts of Dental Credentialing
April 30, 2019
5 Best Features Your PMS Must Have
May 17, 2019

Every industry demands compliance with the rules and set of policies to maintain uniformity. The field of dentistry asks for more uniformity, therefore, the ADA (American Dental Association) and other dental benefits program came with the decision to create a system that would be implemented across all dental offices. However, codes in dental billing come with a lot of confusion. Owing to their constantly changing nature, dental codes are often misunderstood. CDT or Current Dental Terminology codes must be recognized and interpreted well to streamline the billing process. Right from efficiently processing the dental claims to proper documentation, codes play an important role in maximizing claim reimbursement and minimizing risks.

CDT codes are utilized in insurances. They are described as procedure codes that are introduced by the ADA. Proper coding helps in accurately documenting the treatment. CDT could be affecting your practice negatively, if not executed or understood properly. If a practice sends claims with wrong or inaccurate code, it may be convicted of fraud. Dental offices must have the latest version of CDT to help in proper claim billing.

There are a lot of dental practices that suffer every year due to coding errors. Mistakes are unpreventable since dental coding practice keep changing every now and then. If you extract data from the last two years, you will see that approx 135 changes have been done in the coding. Therefore, it is recommended to do a coding review every year.

D9944- Occlusal Guard (Hard Appliance)
It is a new procedure that describes a hard occlusal guard for neutralizing the effects of bruxism. Not reported for any sleep apnea disorder, snoring or TMD appliance. If a patient requires hard occlusal night guard because of night grinding, the appliance is billed using code D9944.

Earlier D9940 was used for occlusal guard but now is segregated into 3 categories, depending on the type of material used.

D9944 (Occlusal guard- hard appliance)
D9945 (Occlusal guard- soft appliance)
D9946 (Occlusal guard- hard appliance, partial arch)

D1516 (Space Maintainer)
Earlier D1515 was used but now it has been divided into three categories, namely:

D1516 space maintainer – fixed – bilateral, maxillary
D1517 space maintainer – fixed – bilateral, mandibular
D1526 space maintainer – removable – bilateral, maxillary
D1527 space maintainer – removable – bilateral, mandibular

D0150- Comprehensive Oral Evaluation
The initial dental examination of a new patient consists of  comprehensive clinical examination of the oral cavity and teeth. It includes charting, history recording, pulp testing when indicated, and may be supplemented by appropriate radio-graphic studies. It may include a periodontal screening and report any soft tissue irregularities, but does not require any recording.

D2940- Protective Filling
This dental code is used for protective restoration wherein a restorative material is directly placed to protect the tooth and tissue form. The procedure helps in relieving pain, enhance healing and prevent further deterioration. It is not meant to be used for endodontic access closure or as a base or liner under restoration.

As professionals in billing, Capline bills the most accurate code to make sure that you get reimbursed faster and reduces chances of errors.