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Code D9994 recommended for documenting interpreter and translator services

September 08, 2016

By Jennifer Garvin

Beginning in January, the new dental case management and patient education code D9994 will be the code the ADA recommends dentists use when billing plans for providing patients with language assistance services or documenting these services.

Providing language assistance at no cost to certain patients with limited English proficiency is one of the provisions of the final rule on Section 1557. Section 1557 is the part of the Affordable Care Act that prohibits entities that receive federal financial assistance from discriminating on the basis of race, color, national origin, age, disability and sex. 

Compliance requirements under the final rule include requiring covered entities to “take reasonable steps to provide meaningful access to individuals with limited English proficiency eligible to be served or likely to be encountered” as well as providing qualified interpreters and translators.  Individuals with limited English proficiency may not be charged for language assistance services; the final rule does not require plans to modify fee schedules to reimburse providers for the service.

According to the Code on Dental Procedures and Nomenclature, Code D9994 applies to any “individual, customized communication of information to assist the patient in making appropriate health decisions” and is “designed to improve oral health literacy, explained in a manner acknowledging economic circumstances and different cultural beliefs, values, attitudes, traditions and language preferences, and adopting information and services to these differences, which requires the expenditure of time and resources beyond that of an oral evaluation or case presentation.”

The ADA reminds dentists that the existence of a CDT Code is not a guarantee of reimbursement for the service by a third-party payer; and also notes that Health Insurance Portability and Accountability Act only requires a third-party payer to accept a CDT Code that is valid on the date of service, and does not mandate coverage. Using this CDT Code documents the provision of the service, regardless of payment considerations.

For more information, visit ada.org/cdt and search “Coding Guidance.”

The ADA released CDT 2017: Dental Procedure Codes and the CDT 2017 Coding Companion: Help Guide for the Dental Team on Aug. 30. There is also the CDT Code Check App available for iOS and Android.

The three products are available as a kit at a discounted price. To order, visit ADAcatalog.org or call 1-800-947-4746. Readers can save 15 percent until Nov. 4 on all ADA Catalog items with promo code 16130.