ADA Announces New Coding Changes Coming to the CDT in 2017

“Is there a code for that?”  That is a familiar question for the business staff that has to match the clinical notes and documentation to a code that exists in the ADA’s current CDT coding manual.  If a code doesn’t exist that properly describes the procedure than we have to use a 999 code or miscellaneous code and a detailed narrative to explain the rationale.

With each New Year the ADA committee brings forth new codes, revised codes and deletes codes that they consider no longer applicable to the current set of codes.

The latest news, March 15, 2016 from Kelly Soderlund of the ADA announces a very important change that welcomes definition of a gray area in coding that has plagued dental insurance coders for years.

“Current codes document treatment procedures for patients with a healthy periodontium or patients with periodontal disease that has accompanying loss of attachment — such as periodontal pockets and bone loss,” said Dr. Ronald Riggins, committee chair. “However, there is no CDT code available to record therapeutic treatment of patients with gingival disease and no attachment loss.”

Current prophylaxis code D1110 documents a preventive procedure that applies to patients with healthy periodontium. There is a jump to codes D4341 and D4342, which are therapeutic procedures indicated for patients who require both scaling and root planing because of loss of attachment. The new code falls under the periodontics category within the CDT manual. As with all CDT codes, any practitioner may deliver the service according to their state’s dental practice act.

The Code Maintenance Committee approved a new scaling code that fills a gap in the continuum of care for patients with gingival disease and no attachment loss.

“Scaling in the generalized presence of moderate or severe gingival inflammation — full mouth, after oral evaluation,” was among 11 new codes and four revisions for CDT 2017. The Code Maintenance Committee held its annual meeting March 3-4 at ADA Headquarters to discuss requests to change add or delete sections of the Code of Dental Nomenclature.

“Because this is new territory for dentists and insurers, several of the groups represented on the Code Maintenance Committee are coming together to develop education material so practitioners may understand and use the new CDT code appropriately.