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2022 AAE Coding Updates

By Elizabeth Shin Perry, D.M.D.

It has been another challenging year and endodontists have continued to adapt to the many changes that the pandemic has presented. As we head into the new year, it is a good time to review and adopt the most recent CDT coding updates that affect our practices.

The recently released ADA CDT 2022 Current Dental Terminology Book contains the most recent changes to the dental codes. The AAE is pleased to report that two new endodontic CDT codes were approved and are now part of the code set for 2022. These codes describe endodontic procedures which had not previously been covered by the CDT codes. The two new codes are:

  • D3911 intraorifice barrier
    • Not to be used as a final restoration.

  •  D3921 decoronation or submergence of an erupted tooth
    • Intentional removal of coronal tooth structure for preservation of the root and surrounding bone.

The intraorifice barrier code represents the ADA’s recognition of the importance of the sealing of the root canal orifice and pulpal floor after root canal therapy has been completed, when the final restoration is not placed during the same visit. As endodontists we are all aware that when an adequate restoration or seal over the root canal filling material is placed at the completion of treatment while under the rubber dam, the overall prognosis of root canal treated teeth is improved. The acceptance of this code was the result of a two year long endeavor which began when, together with the AAE’s Practice Affairs Committee, we wrote and submitted the request for the intraorifice barrier code to the ADA’s Code Maintenance Committee. On March 11, 2021 the Code Maintenance Committee convened virtually and I was honored to represent the AAE and successfully testify for the need for the intraorifice barrier as a new code. The approval of this code will ultimately help to prevent re-infection and loss of teeth due to microleakage and recurrent caries when temporary restorations are lost or compromised. This has been especially important during the pandemic when many patients have experienced a delay in the final restoration after endodontic treatment.

Decoronation or submergence of an erupted tooth is a new code which was submitted with the help of Dr. Nestor Cohenca and the Practice Affairs Committee to address a gap in the CDT code set for decoronation for endodontic scenarios. The approval of this code will address the intentional removal of the coronal tooth structure when preservation of the root will facilitate maintenance or continued development of the bone around ankylosed or fractured teeth. This code is also applicable when extraction is contraindicated due to the risk of medication or radiation-related osteonecrosis.

As with many CDT codes, it can take several years before insurance companies will consider reimbursement for a new code. In the past we have seen insurance companies finally allow coverage after observing increased use of a code by providers and demand for coverage by patients and their employers (e.g. CBCT, regenerative endodontic procedures). Submission of codes for procedures performed also allows for collection of the information in an insurer’s database which can be used for prognosis studies and influence best practices.

The AAE continues to advocate for our members in coding and dental insurance matters. Please send any questions or inquiries to advocacy@aae.org.

Dr. Elizabeth Shin Perry, D.M.D., has been practicing endodontics in Westfield, Massachusetts since 1995 and holds a faculty appointment at the Harvard School of Dental Medicine. She is District I Director of the AAE, a Diplomate of the American Board of Endodontics, and is the ADA Code Maintenance Committee Representative on the AAE’s Practice Affairs Committee.