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CDT 2020, companion, app available for purchase Aug. 26

August 07, 2019

By David Burger

Editor’s note: This is the 26th story in the Decoding Dental Benefits series featuring answers and solutions for dentists when it comes to the world of dental benefits and plans. The series is intended to help untangle many of the issues that can potentially befuddle dentists and their teams so that they can focus on patient care.

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With the CDT 2020 guide about to be released, it is important to note that the Code on Dental Procedures and Nomenclature — better known as the CDT Code — is a living, evolving thing.

In other words, it changes.

For example, there are 63 changes to the code that will be included in CDT 2020 – 37 additions, five revisions, six deletions and 15 editorial revisions.

Even when a specific code is not a new one, or deleted, or amended in any way, confusion about coding is nothing to be shy about.

Luckily for member dentists, then, there are manuals, guides, apps, resources and help provided by the ADA when it comes to coding correctly, which in turn means faster reimbursement.

The ADA publishes the suite of CDT-related publications, with new editions available Aug. 26 before the latest CDT version becomes effective on Jan. 1.

Dr. Po Po Chui, a general dentist in Brookline, Massachusetts, found herself in need of some help this year.

She wanted to know how to differentiate between codes D1110 and D4910, both regarding periodontal therapy, when billing third-party payers.

So, she called the ADA’s Third Party Payer Concierge at 1-800-621-8099.

Dr. Chui reached an ADA representative, who said that reimbursement for either or both procedures is determined by the applicable dental benefit plan provisions, and added that alternating reporting D1110 and D4910 solely to obtain maximum reimbursements from the patient’s dental benefit plan is not appropriate. The representative continued with a look from the clinical perspective, as described in a CDT Companion scenario.

According to the CDT Companion, patients who have received surgical or nonsurgical periodontic therapy would then be placed on a program of periodontal maintenance as described in D4910. The companion notes that if the treating dentist determines that a patient’s periodontal health can be augmented with a periodic routine prophylaxis, delivery of this service and reporting with code D1110 would be appropriate. Nothing in the D4910 or D1110 nomenclatures or descriptors make these procedures mutually exclusive.

“ADA staff was very friendly and helpful,” Dr. Chui said. “First, she verbally explained to me what she knows. Then, she made sure I understood completely by sending me an email with information about this, just to make sure I understood the idea. As a solo practitioner, it is difficult to find information that is reliable and I am glad ADA is there for me.”

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Being able to reach the ADA with questions is why she is a member, Dr. Chui said.

“It was hard to understand why I should join the ADA when I was a dental student,” she admitted. “Not until I hit the road of being a solo practitioner and learning what I wish I had known, I joined the ADA to gain access to vast information and to learn what I was supposed to do when the rubber meets the road.”

Dr. Chui is not the only one to call the ADA when coding questions arise.

Dr. Baret Williams-Furfaro, a dentist in northern Minnesota, contacted the ADA when she didn’t know which tooth numbers should be listed when reporting procedure D1555, removal of fixed space maintainer. The ADA representative told her to report tooth numbers of the missing teeth, then told the doctor about the free ADA publication that addresses when tooth numbers, as well as area of the oral cavity, should be reported for every current CDT code. This online publication is the ADA Guide to Dental Procedures Reported with Area of the Oral Cavity or Tooth Anatomy (or Both).

To access it, type in the name in the search engine on ADA.org.

“I did get the answer I was looking for,” Dr. Williams-Furfaro said. “I was able to call and get an answer right away, in a timely manner.”

Dr. Williams-Furfaro said she was glad she was a member. “I see the ADA as a great resource for dentists,” she said.

Dr. Wesley Burgess, a Dallas dentist, founded his practice in 1952 but even with all that experience, he still needed to contact the ADA with a coding question. He called the ADA and asked why D5281— removable unilateral partial denture, one piece cast metal (including clasps and teeth)— was no longer billable. He learned that D5282 and D5283 —which differentiate between maxillary and mandibular — were now the correct codes, just added in CDT 2019, when D5281 was also deleted.

“They were very knowledgeable,” Dr. Burgess said. “They got me everything I needed.”

In addition to the CDT manual that contains the entire CDT Code set, there is the CDT Coding Companion, which is designed to be used with the CDT manual to train new staff or as a refresher for an experienced team. It will enable more accurate and efficient coding through discussion of key coding concepts, scenarios and Q&A. The third item in this suite of products is the CDT Code Check, the award-winning, handy, searchable app that contains the most up-to-date CDT Codes. It is available for iPhones, iPads and Android mobile devices.

Coding guides that relate to specific procedures and topics are also available at ADA.org/en/publications/cdt/coding-education. Subjects include teledentistry, glucose level monitoring, scaling procedures and impacted teeth removal.

To order the ADA’s Complete CDT 2020 and Companion with Code Check app kit, use promo code 19129 by Oct. 25 to receive 15% on all ADA Catalog resources. Visit adacatalog.org or call 1-800-947-4746.

The ADA’s online landing page for dental benefits information that can help dentists address and resolve even their most vexing questions is at ADA.org/dentalbenefits, part of the ADA Center for Professional Success.

Staff from the Center for Dental Benefits, Coding and Quality can help dentists with dental benefits-related and coding problems, questions and concerns. Call the ADA’s Third Party Payer Concierge at 1-800-621-8099 or email dentalbenefits@ada.org, or for questions on the code email dentalcode@ada.org.

Previous installments in the Decoding Dental Benefits series are available at ADA.org/decoding.