D2392 Resin-based composite, two-surface, back. The tables in this resource link frequently reported CDT codes to one or more possible ICD-10-CM diagnostic codes as examples. Note that these tables, and especially their links, are not all-inclusive, but only serve as a guide for commonly occurring conditions. Dentists, by virtue of their clinical education, experience and professional ethics, are the people responsible for the diagnosis.
As such, the dentist is also required to select the appropriate diagnostic code for patient records and claim filing. It is quite possible that other diagnoses and their associated codes may be appropriate for a given clinical scenario. A regular review of your code can reduce the risk of fraud while ensuring that dental claims are submitted in compliance. The federal government has designated the CDT Code as the national terminology that should be used to inform dental services of claims to third party payers.
Professionals can perform a dental procedure code search to find relevant codes using any of the resources on the ADA code website. The requested service is not covered by the plan for dental care for a specific condition, but a subsidy up to the amount of an alternative covered service is available. This does not include denying or adjusting claims for covered services according to the terms of a member's dental benefit plan. The CDT was designated as the “mandatory standard for electronic communication of dental services.
A key area of concern for many dental offices revolves around dental codes and their ability to correctly code various procedures for insurance purposes. This information is included when the dental hygienist or dentist performs the necessary procedures and, as such, is indicated in the dental claim. If a patient has a gum abscess, which is incised and drained in the office, the procedure can be billed as a dental procedure or a medical procedure. If you file claims for dental benefits as an in-network or out-of-network provider or participate in electronic communications or transactions that fall within the scope of HIPAA, you will use CDT dental codes.
The CDT, maintained by the American Dental Association (ADA), contains all the dental procedure codes necessary to code each dental procedure for submission to a specific dental insurance plan. This means that the patient can go to their dental office or doctor for the same treatment, but different insurance companies will be billed.
