Now is the time to prepare for CDT 2022. CDT procedure codes become effective on January 1 of each calendar year. We use CDT codes to document what we do, and report procedures rendered to third-party payers for reimbursement consideration.
CDT 2022 includes 16 new codes, 14 revised codes, and 6 deleted codes. The simple addition or deletion of a word in a code nomenclature or descriptor can completely change how a code is utilized. Therefore, it is imperative to stay up to date on annual code changes.
Clear accurate record-keeping is crucial for electronic records. Accurate documentation and specificity in code language also allow payers to auto adjudicate more claims thus resulting in a more efficient, quicker payment to your practice.
One important change: Document your discussion with the patient
A notable change for CDT 2022 is the revision to the descriptor for code D0120. The addition of the sentence “The findings are discussed with the patient” brings clarity that all findings or lack thereof are expected to be discussed with the patient. While discussion of findings with the patient has always been expected, this has not always been the case, unfortunately.
Documentation should include what the findings of the evaluation are and/or whether there are no abnormal findings, and that this was discussed with the patient. The revision, addition of language to the descriptor, is reflected in the blue font below.
D0120 periodic oral evaluation – established patient
An evaluation performed on a patient of record to determine any changes in the patient’s dental and medical health status since a previous comprehensive or periodic evaluation. This includes an oral cancer evaluation, periodontal screening where indicated and may require interpretation of information acquired through additional diagnostic procedures. The findings are discussed with the patient. Report additional diagnostic procedures separately.
A second important change: New codes for oral appliances
A second notable change to CDT 2022 is the addition of codes to document oral appliances for treatment of a sleep apnea condition. This new suite of codes includes codes to document the appliance, adjustment, and repair of an appliance. These codes close a gap in CDT. Prior to the addition of these codes, the only code available was D5999 unspecified maxillofacial prosthesis, by report. The use of D5999 required a narrative when reporting to a payer and lacked specificity as to the procedure delivered.
Just because there is a CDT code to document services rendered does not mean a dental plan will consider reimbursement or that it will be reimbursed. An oral appliance fabricated and delivered to treat Obstructive Sleep Apnea conditions is considered medical in nature and should be reported to the patient’s medical insurance. Do not expect reimbursement from dental payers for sleep apnea appliances. The patient’s medical plan is always the primary plan with the dental plan being secondary.
So, how can you be prepared for CDT 2022?
If you haven’t already, purchase a CDT 2022 code book. Investing in a current CDT book is essential for proper, accurate coding. In addition to the CDT 2022 code book, consider purchasing the ADA’s CDT 2022 Coding Companion. The Companion is a plethora of information for the entire dental team.
2022 CDT codes will be available in December in Open Dental as part of a software release. Stay tuned here for updates. You’ll want to update your software and run the D codes tool to import all the updated info.
It is essential for the entire team to be educated on code changes to ensure documentation is accurate, specific, and thorough. Additionally, the submission of deleted codes can delay reimbursement for your practice. Invest in education for your team. Schedule a team meeting in late December or early January to review all changes and documentation requirements related to these changes to ensure coding and record-keeping compliance is implemented for CDT 2022.
About the Author:
Dilaine Gloege is a dental billing author, educator, speaker, and consultant with more than 35 years of dental and insurance claims experience.
She helps dental practice owners succeed through profitable, legitimate insurance claims reimbursement. She speaks, presents, and consults on dental and medical billing nationwide. Dilaine has consulted with staff in thousands of dental practices in her role with Dr. Charles Blair’s Insurance Solutions Newsletter and PracticeBooster. As Director of Education for Dental Claims Academy, she leads programs to help practice owners develop a team of in-house billing experts. Dilaine is the author of a forthcoming book on coordination of benefits. Find her dental coding education articles in the Learning Center at Dental ClaimSupport.