ADA Council Adjusts Approach to CDT Code Enhancement

Posted in Advocacy | July 1, 2023

After a year of extensive study, including the solicitation of feedback from the dental community, the ADA Council on Dental Benefit Programs has announced it will alter its approach to enhancing the CDT Code set.

Initial plans were to add modifiers that could add more patient record details such as materials, the techniques, or the technologies used in a procedure. These two-character codes were designed to complement the existing code set rather than duplicate information already captured elsewhere and would set the stage for more granular information sharing (radiographic view type(s), encounter (visit) circumstances, etc.) that would not only ensure claims could be processed faster, but also provide data to scientists and researchers interested in tracking best-outcomes.

Moving forward, the Council will work with the ADA’s Code Maintenance committee to develop a more robust set of CDT codes, without changing the five-character Dxxxx format. Together they will continue to monitor dental reporting needs to ensure the transmittal of claims information can occur efficiently.

What this means for you:

Offices can continue to utilize the existing CDT code set for both paper and electronic claims transactions; however, Catherine French, the AAE’s Associate Executive Director of Advocacy and Professional Relations suggests members familiarize themselves with upcoming changes to the Dental Claim Form, set for implementation on January 1, 2023. For more information click here: https://www.ada.org/publications/cdt/ada-dental-claim-form?md5=a89df65293c81b61d1e4d115013f2f50

Subtle form changes may require practice management software updates as well as staff education to ensure claims continue to meet payer requirements.

If you have ideas for new, more robust CDT codes, please send those to: advocacy@aae.org.

AAE has and continues to work with payers to address administrative burdens inherent in dental billing. Our staff are always available to assist with coding and billing issues. Please reach out to us at: advocacy@aae.org.