The new year is rapidly approaching, and that means big changes are ahead for your dental practice.
Now is the time to prepare for CDT 2022. CDT procedure codes become effective on January 1 of each calendar year. CDT codes are used for specificity and consistency when documenting dental treatment for a patient. In other words, for any procedure performed on a patient, there is a specific CDT code that corresponds to that procedure, and only it should be used for documentation and claim submission.
At Dental ClaimSupport, it is a priority for our own billing experts to stay up to date on CDT coding. Yearly, codes are created, revised, or even deleted. We want to keep your dental team in the loop as well. Updates to the CDT 2022 include 16 new codes, 14 revised codes and 6 deleted codes.
This article focuses on two important changes that you will see in 2022 CDT. Knowing this information will help you get a more efficient and accurate payment to your practice.
One important change: Document your discussion with the patient
A notable change for CDT 2022 is the revision to the descriptor for code D0120. The addition of the sentence “The findings are discussed with the patient” means that you need to discuss findings (or lack of findings) with your patient.
While discussion of findings with the patient has always been expected, unfortunately, this has not always happened.
Your documentation should include your findings in your evaluation, including whether or not you found anything abnormal, and that this was discussed with the patient. The added language to the descriptor is reflected in the red font below.
D0120 periodic oral evaluation – established patient
An evaluation performed on a patient of record to determine any changes in the patient's dental and medical health status since a previous comprehensive or periodic evaluation. This includes an oral cancer evaluation, periodontal screening where indicated, and may require interpretation of information acquired through additional diagnostic procedures. The findings are discussed with the patient. Report additional diagnostic procedures separately.
A second important change: New codes for oral appliances
A second notable change to CDT 2022 is the addition of codes to document oral appliances for treatment of a sleep apnea condition. This new range of codes includes codes to document the appliance, adjustment and repair of an appliance.
These codes close a gap in CDT. Prior to the addition of these codes, the only code available was D5999 unspecified maxillofacial prosthesis, by report. Use of D5999 required a narrative when reporting to a payer and lacked specificity as to the procedure delivered.
Just because there is a CDT code to document services does not mean a dental plan will consider reimbursement or that it will be reimbursed. An oral appliance to treat Obstructive Sleep Apnea conditions is considered medical in nature and should be reported to the patient’s medical insurance.
The bottom line: Do not expect dental insurance companies to reimburse you for sleep apnea appliances. Instead, send your claim to the patient’s medical plan. For your oral appliance claims, the patient’s medical insurance is always the primary plan with the dental plan being secondary.
So, how can you be prepared for CDT 2022?
If you haven’t already, purchase aCDT 2022 code book. Investing in a current CDT book is essential for proper, accurate coding. In addition to the CDT 2022 code book, consider purchasing the ADA’sCDT 2022 Coding Companion. The Companion provides a wealth of information for your entire dental team.
It is essential for the entire team to learn about code changes. Your knowledge is valuable to ensure your documentation is accurate, specific and thorough, and you collect all the payments you’ve earned. That’s what our own billing experts do for our clients at Dental ClaimSupport.