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  • Attention dentists: CDT updates and other changes for 2017

Attention dentists: CDT updates and other changes for 2017

The newest version of the American Dental Association® (ADA) Code on Dental Procedures and Nomenclature (CDT Code) is effective January 1, 2017. Federal HIPAA law requires the use of CDT Code in electronic health care transactions, and carriers must adopt the ADA changes. Please use CDT 2017 codes when submitting claims to Delta Dental for services provided on or after January 1, 2017.

The CDT updates and other changes for 2017 applicable to the TRICARE Retiree Dental Program (TRDP) include five new procedure codes, several description revisions, and new processing policies to support the new benefits, where appropriate. Following is a summary of these changes; however, please note that coverage for new codes, revised codes and processing policy updates are specific to the patient’s particular federal benefit plan. An updated Federal Government Programs Dental Office reflecting the changes for each of the programs will soon be available on the programs’ websites.

  • New:
    • D1575 Distal shoe space maintainer—fixed—unilateral
    • D4346 Scaling in presence of generalized moderate or severe gingival inflammation— full mouth, after oral evaluation
    • D6081 Scaling and debridement in the presence of inflammation or mucositis of a single implant, including cleaning of the implant surfaces, without lap entry and closure
    • D6101 Debridement of a peri-implant defect or defects surrounding a single implant, and surface cleaning of the exposed implant surfaces, including flap entry and closure
    • D6104 Bone graft at time of placement
  • Revised:
    • D4263
    • D4264
    • D7210
    • D7250
    • D7280
    • D7485
    • D9630
  • Deleted:
    • D0290

Additionally, the following new processing policies are effective January 1, 2017:

  • D1575 — Distal shoe space maintainer—fixed—unilateral
    Distal shoe space maintainer is a benefit to guide the eruption of the first permanent molar and is not covered for patients 14 years and older.
  • D6104 — Bone graft at time of placement
    Bone grafts in conjunction with implants are only a covered benefit at the time of implant placement.
  • Benefit exclusion (not a covered benefit)
    Laser Assisted New Attachment Procedure (LANAP), considered investigational in nature as determined by generally accepted dental practice standards.

Note that other processing policies may have been revised or deleted due to the above-noted changes.

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