Dental Procedure Codes

CDT Procedure Codes Related to Dental Hygiene Procedures

Reviewed By: Kathy Forbes, RDH, BS

Date: June 23, 2019

This is a sampling of the CDT Procedure Codes related to dental hygiene procedures.  This summary does not contain all procedure codes listed in CDT 2018 (pp. 5-92) but addresses some of the more common ones completed by dental hygienists.  See CDT 2018 for complete descriptors and see the CDT Companion Guide for more details.  Additional resources are included with Kathy’s commentary.  

*Signifies a New or updated code (may include link to ADA’s information)

 

Kathy Forbes has a license with the ADA to provide Education about Dental Procedure Codes. 

Diagnostic: pp. 5-13

See “Members Only” Page

Pre-diagnostic Services, pp. 7

See “Members Only” Page

Diagnostic Imaging: pp.  7-8
includes image capture and interpretation

See “Members Only” Page

Frequency determined by Dentist/Hygienist using ADA/CDC recommendations on (See “x-rays” page)

Test and Examination: pp. 10-11

See “Members Only” Page for more specifics

 

D???? HbA1c in-office point of service testing
Used when drawing a blood sample and performing analysis
View ADA Guide PDF
D???? Blood glucose level test
in-office using a glucose meter
D???? Collection and preparation of saliva sample for laboratory diagnostic testing.
Ex. OralDNA®, OraVital®
D???? Collection and preparation of genetic sample material for laboratory analysis and report.
Ex. OralDNA® Pt may need to sign a consent form
D???? Caries Susceptibility test
D???? Ex. CariScreen® See “Cavities” Page for more test options
Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities include premalignant and malignant lesions, not to include cytology or biopsy procedures
D???? Ex. ViziLite®   Plus
Diagnostic casts
D???? Study models
Caries risk assessment and documentation, with a finding of low risk
D???? Must document and use recognized assessment tool; ADA provides downloads forms for patients over the age of 6 and under the age of 6

ADA Guide (Over 6) and ADA Guide (Age 0-6)

D???? Caries risk assessment and documentation, with a finding of moderate risk
D???? Caries risk assessment and documentation, with a finding of high risk
See D0601

Prevention: pp. 15-17

D1110 Prophylaxis-Adult
Permanent and transitional dentition; remove plaque, calculus, stains
D1120 Prophylaxis-Child
Primary and transitional dentition; remove plaque, calculus, stains
D1206 Topical application of fluoride varnish
Any age
D1208 Topical application of fluoride – excluding varnish
Any age
D1310 Nutritional counseling for control of dental disease
To address caries and periodontal disease
D1320 Tobacco counseling for the control and prevention of oral disease
To prevent tobacco-related oral conditions
D1330 Oral Hygiene Instruction
Any home care instruction
D1351 Sealant – per tooth
D1353 Sealant repair-per tooth
D1352 Preventive resin restoration in a moderate to high caries risk patient-permanent tooth
Does NOT extend into dentin; be sure to have caries risk tool completed documenting moderate to high caries risk (see D0602/D0603
D1354 Interim caries arresting medicament application
No removal of sound tooth structure; Examples include Phocal™ and Silver Diamine Fluoride.

Non-surgical Periodontal Service pp. 38-40

See “Members Only” For more specifics

D???? Periodontal scaling and root planing-four or more teeth per quadrant
D???? Periodontal scaling and root planing-one to three teeth per quadrant
D???? Scaling in presence of generalized moderate or severe gingival inflammation-full mouth, after oral evaluation
Moderate to severe gingival inflammation in 30% or more of the mouth. No Bone Loss! (recession, clinical attachment loss)
D???? Full mouth debridement to enable comprehensive evaluation and diagnosis
Not to be completed on the same day as any evaluation; preliminary removal of supra-gingival plaque/calculus; intended to be followed with other definite treatment
D???? Localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue, per tooth.
FDA approved medication
D???? Periodontal maintenance
After SRP, for the life of the teeth or implant, varying intervals, includes site specific SRP as necessary.
D???? Gingival irrigation – per quadrant
Subgingival irrigation with medicinal agent.

Carriers, pp. 56

See “Members Only” Page for more specifics

D???? Fluoride gel carrier
Prosthesis covering the teeth in order to deliver fluoride close to teeth for several minutes per day
D???? Periodontal medicament carrier with peripheral seal-laboratory processed
Ex. PerioProtect™

Implant Services, p.63

See “Members Only” Page for more specifics

D???? Implant maintenance procedure when prostheses are removed and reinserted, including cleansing of prostheses and abutments
For implant supported fixed prostheses.  Debride implant(s) and examine; Patient receives oral hygiene instruction; can be performed with D1110 and D4910
D???? Scaling and debridement in the presence of inflammation or mucositis of a single implant, including cleaning of the implant surfaces, without flap entry and closure
Cannot be used in conjunction with D1110, D4910 or D4346.  Best subgingival biofilm disruption is completed with subgingival polisher (see “Implant” page for more details”)

Anesthesia, pp. 87

D???? Local anesthesia not in conjunction with operative or surgical procedures
Ex. Oraqix®; Kovanaze®
D???? Inhalation of nitrous oxide/analgesia, anxiolysis
Use of nitrous oxide/analgesia

Professional Consultation, pp.89

See “Members Only” Page for more specifics

D???? Consultation with a medical health care professional
When medical professional is consulted about medical issues which could affect patient’s dental treatment
D???? Office visit for observation (during regularly scheduled hours)-no other services performed
 

Drugs, pp.90

See “Members Only” Page for more specifics

D???? Drugs or medicaments dispensed in the office for home use
Topical fluoride, oral antibiotics, oral analgesics, etc.

Miscellaneous Services, pp. 90-91

See “Members Page” for more specifics

D???? Application of desensitizing medicament
Per visit for topical fluoride such as varnish
D???? Application of desensitizing resin for cervical and/or root surface, per tooth
Per tooth; Ex. Gluma®
D???? Cleaning and inspection of removable complete denture, maxillary
D???? Cleaning and inspection of removable complete denture, mandibular
D???? Cleaning and inspection of removable partial denture,

maxillary

D???? Cleaning and inspection of removable partial denture, mandibular
D???? Duplicate/copy patient’s records
D???? External bleaching-per arch-performed in office
Per arch
D???? External bleaching for home application, per arch; includes materials and fabrication of custom trays.
D???? Certified translation or sign language services, per visit
 D???? Teledentistry – synchronous; real time encounter
 D???? Teledentistry – asychronous; information stored and forwarded to dentist for subsequent review
 Mouthwatch are pioneers in the area of teledentistry. They have developed an inexpensive intraoral camera that has received good reviews from dental providers.

FREQUENTLY ASKED QUESTIONS:

Perio maintenance… For life or until stability is achieved?  See “Members Only” Page for answer.

Do I really need to submit codes that we do not charge for (i.e. Caries risk assessment with a low risk finding)? Yes. These codes are tracked and used in the creation or editing of future codes. Also, consider a time in the future when medical and dental billing is combined and a medical provider only sees the dental codes. Those codes should convey not only what was completed, but how the patient was educated and the health of the patient. A D1110, D0602, D1330, D1206 conveys a lot of information.

Can we bill Medical Insurance? See “Members Only” Page for answer.

What if my state practice act allows a Dental Hygienist to perform a particular procedure that is not permitted in the Dental Procedure Code? For example, some states allow RDH’s to perform specific evaluations, while the Dental Procedure Codes specify the evaluation is performed by a Dentist. See “Members Page” for answer (from 2019 Meeting)

How are Codes Developed?

Every March, a committee gathers to discuss and vote on codes. This committee is composted of Dentists, Dental Hygienists, Insurance Representative and others. These individuals discuss and vote on changes that have been proposed. The following October, the new CDT book is published with all of the changes. The changes take effect the following January. The most recent meeting was March 14-15, 2019, in Chicago (at the ADA Headquarters).

Who are the Hygienists’ that are involved?

Dental Hygienists’ from across the country are part of a focus group. They dialogue throughout the year, research and write the changes or new codes they are recommending. There is a particular form to fill out that includes justification for any proposed change.