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‘Evolving’ CDT 2020 on the way after maintenance committee meeting

April 01, 2019

By David Burger

The Code Maintenance Committee in March added a code to the CDT Code that applies to patients with special needs, as well as other codes that fill gaps and have broad applications.

The code applies to “special treatment considerations for patients/individuals with physical, medical, developmental or cognitive conditions resulting in substantial functional limitations, which requires that modifications be made to delivery of treatment to provide comprehensive oral health care services.” It will appear in the case management section of the Code on Dental Procedures and Nomenclature.

The Code Maintenance Committee held its most recent meeting at ADA Headquarters in Chicago on March 15.  The committee convened to address code additions, revisions and deletions submitted for CDT 2020, which goes into effect on Jan. 1, 2020.

One-hundred forty-six requests were addressed during the meeting, said Dr. Mark Mihalo, member of the ADA Council on Dental Benefit Programs and chair of the council’s Coding and Transactions Subcommittee. Of those, 37 additions and two revisions were approved, along with six deletions and 18 editorial changes.

Dental procedures continually advance and the CDT Code provides a means to document services that dentists are delivering, said Dr. Christopher Bulnes, chair of the Code Maintenance Committee as well as chair of the Council on Dental Benefit Programs. “It’s an evolving, live document,” he said, because “the dental industry is moving forward so quickly.”

In regards to the code for patients with special needs, Delta Dental Plans Association wrote in its request that “currently there is no method for identifying dental services provided to patients with special needs. This nonclinical administrative code would facilitate the processing of claims and documentation of services directed at this high-need population. It would also facilitate payment under government and other third-party payer systems where specific fee schedules are provided for services to these patients. One example is the state of Wisconsin, where state legislation provides for a higher payment for Medicaid dental services to qualifying providers, but there is currently no method for providers to identify which patients are eligible for those fees. There is also a lack of data in general on the existing provision of care for patients with special needs due to inability to identify these patients in claims and electronic records.”

Dr. Mihalo said that often treatment of patients with special needs — especially in pediatric practices — requires different procedures or equipment in addition to extra staff being required.

Another approved addition applied to the placement of intra-socket biological dressings to aid in hemostasis or clot stabilization. Prior to this code, only the extraction itself had a code, Dr. Bulnes said. One more addition relates to assessment of salivary flow by measurement, a procedure that helps dentist evaluate patients for hyposalivation and dry mouth, which can be markers for other systemic diseases (e.g., diabetes).

Other changes to the existing CDT Code generally revolved around being more specific, Dr. Bulnes, in regards to implant-supported crowns, implant-supported retainers and orthodontic appliances.

The committee will disseminate a complete report to member organizations and post it May 1 on Code numbers will be assigned in CDT 2020, available this fall. Dentists with questions can email