Reminder to use actual completion date for multi-phase treatment
Please remember to use the actual completion date (or “seat” date) for services such as crowns, bridges, dentures and root canals that require multiple stages or appointments to be completed. Because the date of service is used to establish a patient’s history for dental benefits frequency/time limitations, a service that has not been completed in its entirety but is submitted and paid as if it were completed may result in the denial of additional benefits. If we determine the service was not completed, we will request recovery of any payment.
If you are unable to complete a procedure, please use the appropriate CDT code to submit a claim for the incomplete procedure. For example: A root canal procedure (D3330) was begun but at some point between appointments the tooth was fractured and had to be removed. In this case, the claim for the procedure should be submitted using procedure code D3332 (incomplete endodontic therapy; inoperable, unrestorable or fractured tooth) so that it can be processed correctly for payment.