2021 CDT CODES reflect COVID 19 Tests
*From the American Dental Association:
The committee added the following procedure codes to CDT 2021:
*• D0604 — antigen testing for a public health-related pathogen, including coronavirus.
Definition from the Merriam Webster dictionary:
Antigen is any substance (such as an immunogen or a hapten) foreign to the body that evokes an immune response either alone or after forming a complex with a larger molecule (such as a protein) and that is capable of binding with a product (such as an antibody or T cell) of the immune response
Antigen tests are a swab of the throat or nasal cavity gathered for testing.
*• D0605 — antibody testing for a public health-related pathogen, including coronavirus.
Antibody testing is a blood test to discover whether you have had a past infection with the virus SAR-CoV-2 that causes the COVID 19 disease. The antibody blood test does not identify whether you are currently infected with COVID-19.
According to the American Dental Association, twenty-eight new codes will be added to the CDT Code, effective Jan. 1, 2021.
Why don’t Dental insurance companies cover the codes then – UCCI claims “it is not a dental procedure and it is not listed in the CDT” Why isn’t the ADA putting PUBLIC pressure on insurance companies to cover these new codes?
Hello Jim, thanks for your comment! Unfortunately, just because a code is adopted, it does not imply that carriers will pay for the service. The plans are “sold” to consumers listing the services that are covered under the plan. It does not mean the service is not needed, it just means that the code that was adopted is not a covered service under that policy. The ADA cannot strong arm plans into paying for all services and for the codes that describe the service provided. Codes are adopted to describe treatment(s) provided and the carriers determine what will be covered in the plans they sell to employers and consumers. The provider has the choice to be in network and be limited by the provisions of the plan or choose to stay out of network and bill for what they do without consideration of the plan’s limitations or restrictions. I hope this is helpful to you!