UAB School of Dentistry

1. 8/3/2013
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Code‐ology with Bonus Social Media
Michelle Robinson DMD, MA
Lynne Jarreau, MA
Code‐ology
• Review the process of how codes are maintained at
the ADA
• Gain knowledge of new ADA CDT codes for 2013
• Identify newly released codes, modified codes, and
deleted codes
• Use coding exercises to apply codes effectively

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Disclaimer
Presentation material has been researched using ADA
and other resources but there is no guarantee that
guidelines presented will apply to all plans and
situations.
Importance of Dental Codes
• 5 character alphanumeric code
• Represents a dental treatment procedure
• Starts with letter “D” to ID dental procedure
• Dental procedure codes are compiled in the CDT
(Current Dental Terminology) manual and imported
into your electronic patient record system
• Other codes exist – medical procedures (ICD‐10,
dental diagnosis, SNODENT)

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Why the CDT Code Exists
• Standardize data recording process
• Legal record of treatment performed on patient
• Required for insurance or third party reimbursement
Relationship between CDT and ADA
• The ADA provides dental treatment codes
• Codes are organized in a manual called the Current
Dental Terminology
• Codes have specific descriptors that define their use
• Most claims for dental reimbursement are made on
the ADA claim form, which req these codes

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Using the CDT Codes
• Existence of a code does not imply reimbursement in
a dental benefits plan
• Code grouping into categories does not exclude GPs
from performing/reporting services
• If 2 codes contain similar procedures, claims are
processed using the code selected by the treating
dentist
CDT Code Categories
Category Code Series
Diagnostic D0100-D0999
Preventive D1000-D1999
Restorative D2000-D2999
Endodontics D3000-D3999
Periodontics D4000-D4999
Prosthodontics, removable D5000-D5899
Maxillofacial Prosthetics D5900-D5999
Implant Services D6000-D6199
Prosthodontics, fixed D6200-D6999
Oral Surgery D7000-D7999
Orthodontics D8000-D8999
Adjunctive General Services D9000-D9999

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Code Category Examples
• In what category of codes would
you find
▫ a sealant
▫ caries susceptibility tests
▫ Fixed partial denture sectioning
▫ a soft tissue biopsy
Category Code Series
Diagnostic D0100-
D0999
Preventive D1000-D1999
Restorative D2000-
D2999
Endodontics D3000-
D3999
Periodontics D4000-
D4999
Prosthodontics,
removable
D5000-
D5899
Maxillofacial
Prosthetics
D5900-
D5999
Implant Services D6000-
D6199
Prosthodontics,
fixed
D6200-
D6999
Preventive D1351
Diagnostic D0425
Adjunctive D9120
Oral surgery
D7288
Services Covered by Codes
• Which of the following are NOT represented by a
CDT code ?
▫ Genetic test for susceptibility to oral disease
▫ Tobacco counseling
▫ Nutritional counseling
▫ Electron microscopy
▫ Behavior management
They all are!

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Adjunctive General Services
• Palliative treatments
• Anesthetics/Analgesia not part of routine treatment
• Sedation
• Consults – diagnostic service from dentist or physician
other than practitioner providing treatment
• Office visit – observation ; no other services performed
• Behavior mgmt
• Mouthguards
• Bleaching
• Follow‐up visit
CDT Code Resources
• ADA CDT Code Book
• CDT Code Check App for iPhone, iPad, Android
devices ‐ $20
• ADA toll free number: 1‐800‐947‐4746
• ADA email: dentalbenefits@ada.org
• ADA Code email: dentalcode@ada.org

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Who Maintains the Code
• Code Maintenance Committee
▫ Name change from Code Advisory Committee
▫ Reports to Council on Dental Benefits Programs
▫ Dr. James Richeson (Chair)
▫ 21 member group that studies and decides on all
changes to the CDT
▫ Comprised of reps from ADA, 3rd party payers,
specialty and general dentistry organizations, dental
education
▫ Achieve uniformity, consistency, specificity in reporting
dental treatment
What’s the Process
• Codes updated annually
• Change requests from any source but particularly
dental orgs, ADA, 3rd party payers, or dentists
• 90 change requests submitted (Dec deadline) and
reviewed Feb/Mar 2013 for 2014 update
• Inventory of requests and blank request form:
http://www.ada.org/3827.aspx

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Let’s Get Started with Coding
• Red with strikethrough means code was deleted
• Blue means code was added or modified
• Black indicates text that remained unchanged
• [my comments – not part of the official code
description]

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ADA CDT 2013
• 35 new codes
• 37 revised codes
• 12 deleted codes
• 7 changes to subcategories and their descriptors
Diagnostic Codes
• D0100‐D0999
• 5 changes to subcategories
• 18 new codes
• 15 revised codes
• 2 deleted codes

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New Diagnostic Codes
New subcategory: Pre‐diagnostic services
• New codes:
▫ D0190 screening of a patient
A screening, including state of federally mandated
screenings, to determine an individual’s need to be seen
by a dentist for diagnosis
▫ D0191 assessment of a patient
A limited clinical inspection that is performed to identify
possible signs of oral or systemic disease, malformation,
or injury, and the potential need for referral for diagnosis
and treatment.
Changed Diagnostic Subcategories
Radiographs (Including interpretation) is now Diagnostic
Imaging
Subcategories
• Image Capture with Interpretation (this is what we have
been doing)
• Image Capture Only
▫ Interpretation and Report Performed by a Practitioner Not
Associated With the Capture
• Interpretation and Report Only
▫ Image Capture Performed by a Practitioner Not Associated
With Interpretation and Report

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Changed Diagnostic Codes
Image Capture with Interpretation
• D0210 intraoral complete series of radiographic
images (incl bitewings)
A radiographic survey of the whole mouth, usually consisting of 14‐22
periapical and posterior bitewing images intended to display the crowns and
roots of all teeth, periapical areas and alveolar bone
• D0220 intraoral – periapical first radiographic image
film
• D0230 intraoral – periapical each additional
radiographic image film
Diagnostic: Replacement of Film with
Radiographic image
• D0240 intraoral – occlusal radiographic image film
• D0250 extraoral – first radiographic image film
• D0260 extraoral – each additional radiographic image
film
• D0270 bitewing – single radiographic image film
• D0272 bitewings – two radiographic images films
• D0273 bitewings – three radiographic images films
• D0274 bitewings – four radiographic images films
• D0277 vertical bitewings – 7 to 8 radiographic images
films
This does not constitute a full mouth intraoral radiographic
series.

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Diagnostic: Replacement of Film with
Radiographic image
• D0290 posterior‐anterior or lateral skull and facial
bone survey radiographic image film
• D0321 other temporomandibular joint radiographic
images films, by report
• D0330 panoramic radiographic image film
• D0340 cephalometric radiographic image film
Diagnostic: Deleted Conebeam Codes
Image Capture With Interpretation
Deleted Codes
• D0360 cone beam ct – craniofacial data capture
Includes axial, coronal and sagittal data.
• D0362 cone beam – two‐dimensional image
reconstruction using existing data, includes multiple
images
• New codes created to increase level of detail

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Diagnostic: New Image Capture With
Interpretation Conebeam Codes
• D0364 cone beam CT capture and interpretation with limited
field of view – less than one whole jaw
• D0365 cone beam CT capture and interpretation with field of
view of one full dental arch – mandible
• D0366 cone beam CT capture and interpretation with field of
view of one full dental arch – maxilla, with or without cranium
• D0367 cone beam CT capture and interpretation with field of
view of both jaws with or without cranium
• D0368 cone beam CT capture and interpretation for TMJ series
• including two or more exposures
• D0369 maxillofacial MRI capture and interpretation
• D0370 maxillofacial ultrasound capture and interpretation
• D0371 sialoendoscopy capture and interpretation
Diagnostic: New Image Capture Only Codes
Interpretation and Report Performed by a Practitioner Not Associated With
the Capture
• D0380 cone beam CT image capture with limited field of view –
less than one whole jaw
• D0381 cone beam CT image capture with field of view of one full
dental arch – mandible
• D0382 cone beam CT image capture with field of view of one full
dental arch – maxilla, with or without cranium
• D0383 cone beam CT image capture with field of view of both
jaws, with or without cranium
• D0384 cone beam CT image capture for TMJ series including two
or more exposures
• D0385 maxillofacial MRI image capture
• D0386 maxillofacial ultrasound image capture

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Diagnostic: New Interpretation and Report
Only Codes
Image Capture Performed by a Practitioner Not Associated With
Interpretation and Report
• D0391 interpretation of diagnostic image by a practitioner
not associated with capture of the image, including report
Preventive Codes
• D1000‐D1999
• 1 new code
• 1 revised code
• 2 deleted codes

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Preventive: 2 Codes Replaced by 1
Code deletions
• D1203 topical application of fluoride – child
• D1204 topical application of fluoride – adult
Code addition
D1208 topical application of fluoride
Preventive: Revised Code
• D1206 topical application of fluoride varnish;
therapeutic application for moderate to high caries
risk patients
Application of topical fluoride varnish, delivered in a single visit
and involving the entire oral cavity. Not to be used for
desensitization.

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Restorative Codes
• D2000‐D2999
• 5 new codes
• 5 revised codes
Restorative New Codes
• D2990 resin infiltration of incipient smooth surface lesions
Placement of an infiltrating resin restoration for strengthening,
stabilizing and/or limiting the progression of the lesion.
[PRR = pit/fissure; D2990 = smooth surface]
• D2929 prefabricated porcelain/ceramic crown – primary
tooth
• D2981 inlay repair necessitated by restorative material
failure
• D2982 onlay repair necessitated by restorative material
failure
• D2983 veneer repair necessitated by restorative material
failure
[e.g. material fracture, not iatrogenic]

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Restorative Revised Codes
• D2710 crown – resin‐based composite (indirect)
Unfilled or non‐reinforced resin crowns should be reported using
D2999.
[Lab makes crown from processed resin]
• D2799 provisional crown – further treatment or completion
of diagnosis necessary prior to final impression
Crown utilized as an interim restoration of at least six months
duration during restorative treatment to allow adequate time for
healing or completion of other procedures. This includes, but is
not limited to changing vertical dimension, completing periodontal
therapy or cracked‐tooth syndrome. This is n Not to be used as a
temporary crown for a routine prosthetic restoration.
[long term temp when other work, e.g. Perio, is required on tooth]
Restorative Revised Codes
• D2940 protective restoration
Direct placement of a temporary restorative material to protect
tooth and/or tissue form. This procedure may be used to relieve
pain, promote healing, or prevent further deterioration. Not to be
used for endodontic access closure, or as a base or liner under
restoration.
[this used to be sedative temp]
• D2955 post removal (not in conjunction with endodontic
therapy)
For removal of posts (e.g., fractured posts); not to be used in
conjunction with endodontic retreatment (D3346, D3347, D3348)
• D2980 crown repair, by report necessitated by restorative
material failure
Includes removal of crown, if necessary. Describe procedure.

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Endodontics Codes
• D3000‐D3999
• 1 changes to subcategories
• 1 revised code
Endodontics New Subcategory
Endodontic Retreatment
This procedure may include the removal of a post,
pin(s), old root canal filling material, and the
procedures necessary to prepare the canals and place
the canal filling. This includes complete root canal
therapy.

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Endodontics Revised Code
• D3352 apexification/recalcification/pulpal
regeneration – interim medication replacement
For visits in which the intra‐canal medication is replaced
with new medication and. Includes any necessary
radiographs.
Periodontics Codes
• D4000‐D4999
• 3 new codes
• 7 revised codes
• 1 deleted code

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Periodontics Deleted Code
D4271 free soft tissue graft procedure (including donor
site surgery)
Gingival or masticatory mucosa is grafted to create or
augment the gingiva at another site, with or without
root coverage. This graft may also be used to eliminate
the pull of frena and muscle attachments, to extend the
vestibular fornix, and to correct localized gingival
recession.
[This code replaced with…]
Periodontics New Codes
• D4277 free soft tissue graft procedure (including
donor site surgery), first tooth or edentulous tooth
position in graft
• D4278 free soft tissue graft procedure (including
donor site surgery), each additional contiguous
tooth or edentulous tooth position in same graft
site

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Periodontics Gingivectomy Codes
New Code
• D4212 gingivectomy or gingivoplasty to allow access for restorative
procedure, per tooth
Revised Codes
• D4210 gingivectomy or gingivoplasty – four or more contiguous teeth
or tooth bounded spaces per quadrant
Involves the excision of the soft tissue wall of the periodontal pocket by either an
external or an internal bevel. It is performed to eliminate suprabony pockets after
adequate initial preparation, to allow access for restorative dentistry in the
presence of suprabony pockets, or to restore normal architecture when gingival
enlargements or asymmetrical or unaesthetic topography is evident with normal
bony configuration.
• D4211 gingivectomy or gingivoplasty – one to three contiguous teeth or
tooth bounded spaces per quadrant
[Same revision as 4210 – removed prescriptive info]
Periodontics – Other Revised Codes
• D4260 osseous surgery (including flap entry and
closure) – four or more contiguous teeth or tooth
bounded spaces per quadrant …
This procedure modifies the bony support of the teeth by
reshaping the alveolar process to achieve a more
physiologic form. This may must include the removal of
supporting bone (ostectomy) and/ or non‐supporting bone
(osteoplasty). Other procedures may be required
concurrent to D4260 and should be reported using their
own unique codes.

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Periodontics – Other Revised Codes
• D4261 osseous surgery (including flap entry and
closure) – one to three contiguous teeth or tooth
bounded spaces per quadrant
This procedure modifies the bony support of the teeth by
reshaping the alveolar process to achieve a more
physiologic form. This may must include the removal of
supporting bone (ostectomy) and/or non‐supporting bone
(osteoplasty). Other procedures may be required
concurrent to D4261 and should be reported using their
own unique codes.
Periodontics – Other Revised Codes
• D4266 guided tissue regeneration – resorbable barrier, per
site
This procedure does not include flap entry and closure, or, when indicated, wound
debridement, osseous contouring, bone replacement grafts, and placement of biologic
materials to aid in osseous regeneration. This procedure can be used for periodontal
and peri‐implant defects.
A membrane is placed over the root surfaces or defect area following surgical
exposure and debridement. The mucoperiosteal flaps are then adapted over the
membrane and sutured. The membrane is placed to exclude epithelium and gingival
connective tissue from the healing wound. This procedure may require subsequent
surgical procedures to correct the gingival contours. Guided tissue regeneration may
also be carried out in conjunction with bone replacement grafts or to correct
deformities resulting from inadequate faciolingual bone width in an edentulous area.
When guided tissue regeneration is used in association with a tooth, each site on a
specific tooth should be reported separately. Other separate procedures may be
required concurrent to D4266 and should be reported using their own unique codes.

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Periodontics – Other Revised Codes
• D4267 guided tissue regeneration – non‐resorbable barrier,
per site (includes membrane removal)
This procedure does not include flap entry and closure, or, when indicated,
wound debridement, osseous contouring, bone replacement grafts, and
placement of biologic materials to aid in osseous regeneration.
This procedure is used to regenerate lost or injured periodontal tissue by directing
differential tissue responses. A membrane is placed over the root surfaces or defect
area following surgical exposure and debridement. The mucoperiosteal flaps are then
adapted over the membrane and sutured. This procedure does not include flap entry
and closure, wound debridement, osseous contouring, bone replacement grafts, or
the placement of biologic materials to aid in osseous tissue regeneration. The
membrane is placed to exclude epithelium and gingival connective tissue from the
healing wound. This procedure requires subsequent surgical procedures to remove
the membrane and/or to correct the gingival contours. Guided tissue regeneration
may be used in conjunction with bone replacement grafts or to correct deformities
resulting from inadequate faciolingual bone width in an edentulous area. When
guided tissue regeneration is used in association with a tooth, each site on a specific
tooth should be reported separately with this code. When no tooth is present, each
site should be reported separately. Other separate procedures may be reported
concurrent to D4267 and should be reported using their own unique codes.
Periodontics – Other Revised Codes
• D4381 localized delivery of antimicrobial agents via
a controlled release vehicle into diseased crevicular
tissue, per tooth, by report
FDA approved subgingival delivery devices containing antimicrobial
medication(s) are inserted into periodontal pockets to suppress the
pathogenic microbiota. These devices slowly release the
pharmacological agents so they can remain at the intended site of
action in a therapeutic concentration for a sufficient length of time.
[Restin cartridge is per site. Code is per tooth. Choose fee to average it
out]

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Prosthodontics (Removable) Codes
• D5000‐D5899
• No Additions
• No Revisions
• No Deletions
Maxillofacial Prosthetics Codes
• D5900‐D5999
• No Additions
• No Revisions
• No Deletions

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Implant Services Codes
• D6000‐D6199
• 5 new codes
• 2 revised codes
Implants – New Codes
• D6101 debridement of a periimplant defect and surface cleaning
of exposed implant surfaces, including flap entry and closure
[soft tissue only]
• D6102 debridement and osseous contouring of a periimplant
defect; includes surface cleaning of exposed implant surfaces and
flap entry and closure
[soft and hard tissue]
• D6103 bone graft for repair of periimplant defect – not including
flap entry and closure or, when indicated, placement of a barrier
membrane or biologic materials to aid in osseous regeneration
[bone graft]
• D6104 bone graft at time of implant placement – not including,
when indicated, flap entry and closure, placement of a barrier
membrane, or biologic materials to aid in osseous regeneration
[bone graft at time of placement]

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Implants – New Interim Abutment Code
• D6051 interim abutment
Includes placement and removal. A healing cap is
not an interim abutment.
Implants –Revised Codes
Revised Codes – clarify and shorten descriptions
• D6056 prefabricated abutment – includes modification and
placement
A connection to an implant body that is a manufactured component,
usually made of machined high noble metal, titanium, titanium alloy or
ceramic. Modification of a prefabricated abutment may be necessary
and is accomplished by altering its shape using dental burs/diamonds.
• D6057 custom fabricated abutment – includes placement
A connection to an implant body that is a fabricated component,
usually by Created by a laboratory process, specific for an individual
application. A custom abutment is usually fabricated using a casting
process and usually is made of noble of high noble metal. A “UCLA”
abutment is an example of this type of abutment.

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Prosthodontics, Fixed Codes
• D6200‐D6999
• 1 addition to category of service
• 4 revised codes
• 7 deleted codes
Prosthodontics, Fixed
Addition of category of service descriptor
• The term “fixed partial denture” replaces the words
“bridge” and “bridgework” throughout this section.
• Fixed partial denture prosthetic procedures include
routine temporary prosthetics. When indicated,
interim or provisional codes should be reported
separately.

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Prosthodontics, Fixed Revised Codes
• D6253 provisional pontic – further treatment or
completion of diagnosis necessary prior to final
impression
Pontic utilized as an interim of at least six months duration during
restorative treatment to allow adequate time for healing or
completion of other procedures. This is n Not to be used as a
temporary pontic for routine prosthetic fixed partial dentures
• D6793 provisional retainer crown – further treatment
or completion of diagnosis necessary prior to final
impression
Retainer crown utilized as an interim of at least six months duration
during restorative treatment to allow adequate time for healing or
completion of other procedures. This is n Not to be used as a
temporary retainer crown for routine prosthetic fixed partial dentures.
Prosthodontics, Fixed Revised Codes
• D6975 coping – metal
To be used as a definitive restoration when coping is an
integral part of a fixed prosthesis.
• D6980 fixed partial denture repair, by report
necessitated by restorative material failure

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Prosthodontics, Fixed Deleted Codes
• D6254 interim pontic
Pontic used as an interim restoration for a duration of less than six
months when a final impression is not made to allow adequate
time for healing or completion of definitive treatment planning.
This is not a temporary pontic for routine prosthetic fixed partial
denture restoration.
[Use provisional pontic]
• D6795 interim retainer crown
Retainer crown used as an interim restoration for a duration of less
than six months when a final impression is not made to allow
adequate time for healing or completion of definitive treatment
planning. This is not a temporary retainer crown for routine
prosthetic fixed partial denture restoration.
[Use provisional retainer crown]
Prosthodontics, Fixed Deleted Codes
• D6970 post and core in addition to fixed partial denture
retainer, indirectly fabricated
Post and core are custom fabricated as a single unit.
• D6972 prefabricated post and core in addition to fixed
partial denture retainer
• D6973 core buildup for retainer; including any pins
• D6976 each additional indirectly fabricated post – same
tooth
To be used with D6970.
• D6977 each additional prefabricated post – same tooth
To be used with D6972.
[FPD post/cores removed]

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Oral & Maxillofacial Surgery Codes
• D7000‐D7999
• 2 new codes
• 1 revised code
Oral & Maxillofacial Surgery New Code
• D7921 collection and application of autologous
blood concentrate product
[Blood concentrate packed in wounds/used in surgical procedures]
• New sinus augmentation code

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Oral & Maxillofacial Surgery Codes
Sinus Augmentation Codes
Revised code
• D7951 sinus augmentation with bone or bone
substitutes via a lateral open approach
The augmentation of the sinus cavity to increase alveolar height for
reconstruction of edentulous portions of the maxilla. This procedure is
performed via a lateral open approach. This includes obtaining the bone or
bone substitutes. Placement of a barrier membrane if used should be
reported separately.
New code
• D7952 sinus augmentation via a vertical approach
The augmentation of the sinus to increase alveolar height by
vertical access through the ridge crest by raising the floor of the
sinus and grafting as necessary. This includes obtaining the bone
or bone substitutes.
Orthodontics Codes
• D8000‐D8999
• No Additions
• No Revisions
• No Deletions

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Adjunctive General Services Codes
• D9000‐D9999
• 1 new code
• 1 revised code
Adjunctive General Services Codes
New Code
• D9975 external bleaching for home application, per
arch; includes materials and fabrication of custom
trays
Revised Code
• D9972 external bleaching – per arch – performed in
office

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What happens if your procedure does not
have a code that fits?
• Use “Miscellaneous” codes
▫ D6999 = unspecified fixed partial denture procedure,
by report
 Addtl info must be provided
▫ D2999 = unspecified restorative procedure, by report
 Include note explaining procedure
Top Coding Errors

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Code Not Valid
• Modified Codes
▫ A modified version of a code is used to denote a
difference in treatment or cost
▫ 3rd party payers usually will not recognize
• Inactive Codes
▫ Delete old codes annually with CDT update
▫ Pull code reports with fees and counts for tracking
• Nonexistent codes
Common Coding Errors ‐ Diagnostics
• Scenario: You are taking 3 X‐rays on a patient. The
first X‐ray code is D0220. Each additional X‐ray is
D0230. Different codes and different fees exist. Full
mouth X‐ray set has its own code
• 4 codes for bitewings:
▫ Single: D0270
▫ Two: D0272
▫ Four: D0274
▫ Vertical: D0277 (7‐8 films)

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Comprehensive Oral Exams
• D0150 for comprehensive exam for patient over 3
years old
• D0145 for patient under age 3
• D0180 for perio patients
• Typical frequency limits
▫ 2/year or 1/6 months
Oral Evaluation Codes
Description Code
Periodic exam (recall) D0120
Limited/problem-focused (emergency) D0140
Oral eval – patient under 3 yrs old D0145
Comprehensive D0150
Comprehensive perio D0180
Detailed (extensive problem-focused) D0160
Re-evaluation/limited (reassessment,
problem-focused)
D0170
Screening (determine need to be seen) D0190
Assessment (limited inspection for disease.etc) D0191

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Exam Code Descriptors
• 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 and periodontal screening where indicated,
and may require interpretation of information
acquired through additional diagnostic procedures.
Exam Code Descriptors
• D0140 limited oral evaluation – problem focused
An evaluation limited to a specific oral health problem
or complaint. This may require interpretation of
information acquired through additional diagnostic
procedures. Report additional diagnostic
procedures separately. Definitive procedures may be
required on the same date as the evaluation.

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Exam Code Descriptors
• D0150 comprehensive oral evaluation – new or
established patient
Used by a general dentist and/or a specialist when
evaluating a patient comprehensively. This applies to
new patients; established patients who have had a
significant change in health conditions or other
unusual circumstances, by report, or established
patients who have been absent from active treatment
for three or more years.
Exam Code Descriptors
• D0160 detailed and extensive oral evaluation – problem
focused, by report
A detailed and extensive problem focused evaluation
entails extensive diagnostic and cognitive modalities based
on the findings of a comprehensive oral evaluation.
Integration of more extensive diagnostic modalities to
develop a treatment plan for a specific
problem is required. The condition requiring this type of
evaluation should be described and documented.
Examples: dentofacial anomalies, complicated perio‐
prosthetic conditions, complex TMJ

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Exam Code Descriptors
• D0170 re‐evaluation – limited, problem focused
(established patient; not post‐operative visit)
Assessing the status of a previously existing condition.
Examples: a traumatic injury where no treatment was
rendered but patient needs follow‐up monitoring;
evaluation for undiagnosed continuing pain;
soft tissue lesion requiring follow‐up evaluation.
Exam Code Descriptors
• D0180 comprehensive periodontal evaluation – new or
established patient
This procedure is indicated for patients showing signs or
symptoms of periodontal disease and for patients with risk
factors such as smoking or diabetes. It includes evaluation
of periodontal conditions, probing and charting, evaluation
and recording of the patient’s dental and medical history
and general health assessment. It may include the
evaluation and recording of dental caries, missing or
unerupted teeth, restorations, occlusal relationships and
oral cancer evaluation.

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Exam Code Descriptors –
Pre‐diagnostic Services
• D0190 screening of a patient
A screening, including state or federally mandated
screenings, to determine an individual’s need to be
seen by a dentist for diagnosis.
• D0191 assessment of a patient
A limited clinical inspection that is performed to
identify possible signs of oral or systemic disease,
malformation, or injury, and the potential need for
referral for diagnosis and treatment.
Conebeam
• 2 separate codes for the capture and interpretation
of images. Can we charge the patient twice?
▫ Only if the capture and interpretation occur in
separate offices

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Common Coding Errors – Restorative
• Resin‐based composite
▫ Separate codes for anterior and posterior
• Single crowns are listed in the Restorative section
(2000 category). Bridges (FPD) are listed in the Fixed
Pros section (6200‐6999)
• Cannot code separately for a procedure that is a
routine part of a treatment
▫ Don’t use provisional crown code (D2799) if the
provisional is a temporary restoration for a crown or
bridge in progress
Common Coding Errors ‐ Endodontics
• Cannot code separately for a procedure that is
a routine part of a treatment
▫ Don’t use pulpotomy code (D3220) if the
removal of coronal pulp is planned as the first
stage of root canal therapy
▫ Root canal therapy involves the taking of several
X‐rays. Should this be coded and charged
separately using the first X‐ray code (D0220) and
additional X‐ray codes (D‐0230) for each one?

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Common Coding Errors ‐ Periodontics
• Crown lengthening – hard tissue procedure
▫ Can use new code D4212 code for soft tissue
gingivectomy for restorative access
• Scaling/Root Planing: D4341 for >=4 teeth and
D4342 for 1‐3 teeth
• D4910 usually follows sc/rp or osseous surgery
Common Coding Errors ‐ Prosthodontics
• Cerec crown is D2740: porc/ceramic substrate
• Classification of materials
▫ High noble (HN) metal vs. Noble metal vs Base metal
▫ Porcelain/ceramic vs. resin
▫ Resin base vs. metal base
• D6080: implant maintenance procedures, including
removal of prosthesis, cleansing of prosthesis and
abutments and reinsertion of prosthesis

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Common Coding Errors – Oral Surgery
• The following are commonly used extraction codes.
Other than different fees, what makes the following
codes dissimilar?
▫ D7111
▫ D7140
▫ D7210
• D7111 extraction, coronal remnants – deciduous tooth
Removal of soft tissue‐retained coronal remnants.
• Routine extraction: D7140 extraction, erupted tooth or
exposed root (elevation and/or forceps removal)
Includes routine removal of tooth structure, minor
smoothing of socket bone, and closure, as necessary.
• Surgical extraction: D7210 surgical removal of erupted
tooth requiring removal of bone and/or sectioning of
tooth, and including elevation of mucoperiosteal flap if
indicated
Includes related cutting of gingiva and bone, removal of
tooth structure, minor smoothing of socket bone and
closure.

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“Scrutiny” Codes
• Radiographs – due to frequency
• Prophy – due to frequency
• Gross debridement – due to cost
• Crown lengthening – due to GP abuse
• Restorative tooth surfaces – due to abuse
• D2950 Core buildup – must be for retention of crown
and strength of tooth (about 65% of tooth missing)
Office Coding Efficiency
• Conduct annual review of codes and fees
• Delegate to office staff who will stay current and
communicate often with insurance companies
• Create a commonly used code sheet