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Letters: CDT Code Letter

March 19, 2012

The Jan. 16 ADA News was very interesting, especially the article on the new committee to maintain the CDT Code especially since the committee wants to "consider all points of view" ("ADA Creates New Committee, Process to Maintain CDT Code").

Understanding the code and how it applies to performing procedures and billing for services is of utmost importance not only to dentists but to patients. From my point of view, I feel the code is lacking in what the procedure code definition excludes. For example, all dentists would concede that local anesthesia would be an included part of an extraction, despite there being a separate code for local anesthesia and a separate code for an extraction. Dentists would not "unbundle" the code. Dental benefit providers use the codes to process benefit disbursements/payments and determine processing policies. Processing policies (proprietary to each dental benefit provider) define for them what the procedure code includes/excludes.

In other words, dental benefit providers are given license to "re-define" what they believe a code includes and call it a processing policy. One of several examples would be procedure codes D2750 and D2950. Many dental benefit providers are denying core buildups with a processing policy that D2950 is considered part of D2750.

When questioned, the dental benefit provider makes a statement that it is doing so as part of a processing policy since it is how they interpret D2750. I urge the committee to be more specific in their wording of the definitions of the codes so they completely define what is and what is not considered part of the procedure. In this way, we can honestly maintain the integrity of our code.

Andrew Gazerro III, D.M.D.
West Warwick, R.I.