ADA News

The first use of the Code Revision Committee Appeal Committee was a successful one for the ADA, with three additions added to the Code on Dental Procedures and Nomenclature.

The ADA Council on Dental Benefit Programs initiated the committee and worked with past and present members of the CRC to implement the process. The appeal committee was formed to address ADA or payer change requests that were declined because of a tie vote in the CRC.

The success is significant because the process is more responsive to the recording needs of the procession. "The Appeal Committee's decisions affirm the ADA's position that dentists need appropriate codes for every procedure they perform and that the presence or absence of dental benefit plan coverage is irrelevant," said Dr. Bert Oettmeier, chair of the CDBP.

The Appeal Committee met May 24 to address three declined additions that were appealed by the ADA's CRC representatives. The three additions were new codes to document harvesting bone to be used in grafts, placement of an interim pontic and placement of an interim retainer crown.

There are 12 voting members on the CRC, evenly balanced between dentistry's practitioner and payor sectors. The six ADA representatives are nominated by the CDBP and appointed by the ADA president.

Association members argued that the Code should have sufficient detail to accurately document services provided; payers must defer to dentists to make the critical decisions about what necessary procedures require a code; and the use of a unspecified procedure by report makes the Code less accurate and inconsistent with electronic health records and data exchange.

These three additions bring the new procedure codes this cycle, effective Jan. 1, 2011, to eight along with 19 revisions. There were no deletions.

CDBP is already working on requests to be submitted for the Code effective Jan. 1, 2013. The closing date for requests is Oct. 1.

The next revision and review timetable is posted on www.ada.org and the first batch of Code change requests will be addressed during the February 2011 CRC meeting.

The revision process is open, and all dentists are encouraged to submit their requests.

Information is available online at www.ada.org/goto/dentalcode or by contacting the ADA Member Service Center toll free.