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New Code Advisory Committee finds success in dialogue

March 05, 2012

By Kelly Soderlund, ADA News staff

It was a different vibe than in previous discussions about the Code on Dental Procedures and Nomenclature but one that was more collaborative, collegial and overall better, according to members of the ADA Council on Dental Benefit Programs.

The Code Advisory Committee had its first meeting Feb. 10-11 at ADA Headquarters. CDBP members described the meeting as positive, transparent and containing thoughtful dialogue, among many other adjectives.

“The ultimate message is that the ADA is committed to a very fair and open process and we think we’ve made a big step in the right direction with that and we got good input from all of the different stakeholders,” said Dr. Jim Richeson, CDBP chair, who also sits on the CAC.

Open discussion: Dr. Bert Oettmeier (right), chair of the Code Advisory Committee, and Dr. Stephen Ura, chair of the Subcommittee on the Code and vice chair of the Council on Dental Benefit Programs, listen to testimony from the committee.

The ADA Board of Trustees approved the formation of the CAC to support the council’s ongoing maintenance of the CDT Code. The advisory committee includes five current or past council members, one representative from each of the nine recognized dental specialty organizations, one representative from the Academy of General Dentistry, one representative from the American Dental Education Association and one representative from each of the five payer organizations formerly on the Code Revision Committee, including the Centers for Medicare & Medicaid Services and one representative from the American Dental Education Association. The composition of the CAC may change over time.

Nearly 75 people were in attendance at the CAC meeting, either at the main table where the official members sat, an outer ring table containing support staff of the representative parties or in the audience, where anyone from the public could listen and provide testimony. All CAC meetings are open to any interested party, including other dental organizations or suppliers and payer entities that may not be directly represented on the advisory committee. In addition to the microphones provided for the CAC members around the inner table, there were microphones set up in the aisles so audience members could provide input, which quite a few did.

“The atmosphere was different; it was less contentious than in meetings of the Code Revision Committee. It was really just information gathering,” said Dr. Bert Oettmeier, CAC chair and CDBP member.

“It seemed to be well-received by everybody at the table, and we even heard positive comments from the audience,” said Dr. Stephen Ura, chair of the Subcommittee on the Code and vice chair of CDBP.

One concern Dr. Ura heard was the lack of voting at the CAC. Voting used to take place at meetings of the Code Revision Committee, which existed prior to the establishment of the CAC.

“However, the fact that there was no voting at the CAC meeting promoted a very collegial discussion that will ultimately result in the best changes in the CDT Code,” Dr. Ura said.

“One of the downsides, in my view, of the CRC was the voting,” Dr. Richeson said. “It often got contentious. Then you got away from the open dialogue and the collaboration and really trying to work out what was best for the patients and the profession as a whole.”

Break time: Dr. Oettmeier talks with Cindy Hake from the Centers for Medicare & Medicaid Services during a break.
The purpose of the CAC is to collect opinions on changes to the CDT Code. That information will be taken to CDBP’s Subcommittee on the Code March 16-17. The subcommittee’s recommendations will go out to all CAC members and be posted on for comment. These recommendations, along with the comments received, will be taken up by CDBP for action at its April meeting.

CDBP will vote on each action item and the results and rationale will be posted on The decisions can then be appealed, if the appeal is based on new information, to the council by those who submitted the proposed but not adopted CDT Code changes.

The final actions by CDBP will be included in the next version of the CDT Code, effective Jan. 1, 2013. This version will also include changes already passed by the CRC when it met in 2011.

“The council is interested in making sure the purpose of the CDT Code is accomplished, which is to ensure uniformity, consistency and specificity when performing dental treatments,” Dr. Oettmeier said. “I think the process now will better allow for it than the old process. It is also very important to understand that the CDT Code’s purpose in documenting dental services has been in place for more than 10 years. This hasn’t changed. The ADA supports this purpose as well as its ancillary use in dental claim adjudication.”

CDBP members believe the first meeting achieved the initial goal of soliciting candid comments from stakeholders involved in the development of the CDT Code.

“The real telling thing for me during the conference itself was there was better discussion, better collaboration, more open discussion than I ever recall having at CRC meetings,” Dr. Richeson said.