Code updates effective in January 2024

Starting January 2024, updates to the Code on Dental Procedures and Nomenclature will go into effect. Commonly known as Current Dental Terminology (CDT), the HIPAA-designated code set for electronic dental data interchange serves as the national standard for reporting dental services and is a primary means of communication between dentists and dental benefits payers.

Any electronically submitted dental claim on a HIPAA-standard electronic dental claim must use procedure codes from the current version of the CDT. The Code is also utilized for dental claims submitted on paper.

The American Dental Association (ADA) conducts an annual review and revision of the Code with the revised version effective on Jan. 1 annually. The upcoming revision, published as CDT 2024: Dental Procedure Codes by the ADA, will be effective from Jan. 1, 2024, and will cover services provided until Dec. 31, 2024.

The 2024 version of the CDT Code incorporates notable changes, featuring 14 new procedure code entries, two revised procedure code entries, and the introduction of one new category of service.

Newly added codes include:

  • A code for 3D printing of a 3D dental surface scan.
  • A code for immunization counseling.
  • A code for band stabilization.
  • A code to be used for the excavation of a tooth resulting in the determination of non-restorability.
  • A code for the application of hydroxyapatite regeneration medicament.
  • A code for accessing and retorquing loose implant screw.
  • A code for excisional biopsy of minor salivary glands.
  • A code for indexing for osteotomy using dynamic robotic assisted or dynamic navigation.
  • Two new codes for the fabrication and placement of a custom removable clear plastic temporary aesthetic appliance.
  • Two new codes for oral appliance therapy including fabrication, delivery, and a titration visit.
  • A new code for administration of home sleep apnea test.
  • A new code for the screening for sleep-related breathing disorders.

Along with the CDT 2024 procedure code changes, the following claim and processing procedures will be effective January 1, 2024:

 

Benefit coverage:

  • Code D2976 (band stabilization-per tooth) will be covered once per tooth per lifetime on posterior permanent teeth.
  • Code D2991 (application of hydroxyapatite regeneration medicament-per tooth) will be covered twice per tooth per benefit year.
  • Code D6089 (accessing and retorquing loose implant screw - per screw) will be covered once every 24 months when there is coverage for implants.
  • Code D7284 (excisional biopsy of minor salivary glands) will be covered twice per lifetime when there is coverage for oral surgery.

New procedure codes and associated processing policies:


​​​​Diagnostics:

D0396 (3D printing of a 3D dental surface scan) is inclusive of other procedures and is NOT BILLABLE TO THE PATIENT.
 

Preventive:

D1301(immunization counseling) Benefits are DENIED unless covered by group/individual contract.
 

Restoration:

D2976 (band stabilization–per tooth)

D2989 (excavation of a tooth resulting in the determination of non-restorability) is considered an incomplete service, and the fees are NOT BILLABLE TO THE PATIENT.

D2991 (application of hydroxyapatite regeneration medicament–per tooth) fees for D2991 on the same tooth and on the same date of service as a restoration [D2000-D2999] or procedures D6545-D6794 are NOT BILLABLE TO THE PATIENT by the same dentist/dental office. Fees for restorations placed within 6 months of D2991 are NOT BILLABLE TO THE PATIENT by the same dentist/dental office. Fees for D1354 on the same tooth and on the same date of service as D2991 are NOT BILLABLE TO THE PATIENT.
 

Implant Services:

D6089 (accessing and retorquing loose implant screw—per screw) When implants are covered by the group/individual contract, the fee for D6089 are NOT BILLABLE TO THE PATIENT on the same date of service by same dentist/dental office as D6080 or D6090.

 

Oral & Maxillofacial Surgery:

D7284 (excisional biopsy of minor salivary glands) The fee for biopsy of oral tissue is included in the fee for a surgical procedure (e.g., apicoectomy, extractions, etc.) and is NOT BILLABLE TO THE PATIENT when performed by the same dentist/dental office in the same surgical area and on the same date of service.

D7939(indexing for osteotomy using dynamic robotic assisted or dynamic navigation) Benefits are DENIED as specialized technique.

 

Adjunctive General Services:

D9938 (fabrication of a custom removable clear plastic temporary aesthetic appliance) Benefits are DENIED unless covered by group/individual contract.

D9939 (placement of a custom removable clear plastic temporary aesthetic appliance) Benefits are DENIED unless covered by group/individual contract.

D9954 (fabrication and delivery of oral appliance therapy (OAT) morning repositioning device) Benefits are DENIED unless covered by group/individual contract.

D9955 (oral appliance therapy (OAT) titration visit) Benefits are DENIED unless covered by group/individual contract.

D9956 (administration of home sleep apnea test) Benefits are DENIED unless covered by group/individual contract.

D9957 (screening for sleep related breathing disorders) Benefits are DENIED unless covered by group/individual contract.

 

With all the new code changes, we recommend that dentists and dental offices verify covered services for patients before rendering treatment. Details of individual coverage can be verified by logging in to the Dental Office Toolkit®.

Accurate coding promotes faster claim processing and fewer errors. Delta Dental recommends each dental office have a current copy of the CDT Code to stay current with procedure coding. To order a copy of the 2024 CDT Code, call the ADA at 800-947-4746, or visit  www.adacatalog.org