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Code Maintenance Committee approves new codes associated with vaping, teledentistry

CDT Code for 2021 will provide greater specificity for accurate patient record-keeping, easier claim processing

April 02, 2020

By David Burger

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Editor’s note: This is the 30th 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.

On the heels of the ADA’s December interim policy on vaping comes a new CDT code that references counseling services about high-risk substance use including vaping.

That is just one of the 26 additions to what will be the 2021 CDT Code set, along with seven revisions, four deletions and 22 editorial changes (actions that clarify without changing the CDT Code entry procedure’s purpose or scope).

“The Code Maintenance Committee accepted a number of change requests this year that removed ambiguity from existing CDT Code entries and added codes that more clearly describe services being delivered today,” said Dr. Randall Markarian, chair of the Code Maintenance Committee and ADA Council on Dental Benefit Programs.

The Code Maintenance Committee met March 12 at ADA Headquarters in Chicago to discuss changes that will become effective on Jan. 1, 2021.

One new code of note regards “counseling services [that] may include patient education about adverse oral, behavioral, and systemic effects associated with high-risk substance use and administration routes. This includes ingesting, injecting, inhaling and vaping. Substances used in a high-risk manner may include but are not limited to alcohol, opioids, nicotine, cannabis, methamphetamine and other pharmaceuticals or chemicals.”

The CDT Code includes one (D1320) for tobacco counseling and one (D1310) for nutritional counseling, but there had been no procedure code for counseling for high-risk substance use that may lead to adverse health effects, said the American Codeology Consortium, in its request for the new code.

“The Centers for Disease Control and Prevention DC has issued warning against use of all vaping devices effective September 2019 surrounding the risk of acute severe lung disease,” the consortium said in its request. “The list of negative long term oral and systemic effects of electronic cigarette use is widening and forthcoming. The U.S. Surgeon General has issued warnings regarding the ‘epidemic of teen vaping’ and associated dangers.”

On Dec. 19, American Dental Association President Chad P. Gehani announced that the Association adopted a new interim policy on vaping. The interim policy calls for a total ban on all vaping products that aren’t approved by the Food and Drug Administration for tobacco cessation purposes.

In addition to this interim policy, in September, the ADA House of Delegates passed a resolution stipulating that the word “vaping” and any other alternative nicotine delivery systems be added to the existing ADA policy focused on tobacco use prevention, research and regulation. The interim policy expands upon the Association’s 2016 tobacco policy.

Nine new diagnostic imaging codes are relevant to patient care delivered through teledentistry, a delivery modality documented separately with codes added in CDT 2018. These new codes are for radiographic and photographic image capture-only procedures. These procedures have the greatest applicability in teledentistry encounters where a locally licensed practitioner captures images that are forwarded to a dentist for interpretation. The dentist then reports interpretation separately with its own CDT code.

“There are two other additions and an accompanying deletion that are also worth noting that are an inelegant but necessary solution to an ongoing claim adjudication conundrum,” Dr. Markarian added.

He was referring to the deletion of the single code D5994 and addition of codes that specify the arch to which this medicament carrier procedure applies.  

“It is an expedient short-term solution to timely claim processing and reimbursement,” continued Dr. Markarian, “but the better solution as we move deeper into electronic patient records and claim submission  is to make use of the Area of the Oral Cavity field on both the paper and HIPAA electronic dental claim formats. Everyone — dentists and payers — should be reporting and processing the Area of the Oral Cavity codes as they have been published for years.”

The ADA Council on Dental Benefit Programs established its Code Maintenance Committee to ensure that all stakeholders have an active role in evaluating and voting on CDT Code changes. It is the body that votes to accept, amend or decline requests. The CMC is expected to arrive at decisions that are in the best interests of the profession and patients, and third-party payers/administrators.

The ADA has also created an online landing page for dental benefits information that can help dentists address and resolve even their most vexing questions. Visit 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 dentalcode@ada.org for coding questions.

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