NEW CDT 2019 Coding Companion: Help Guide for the Dental Team A crack coding team starts with solid training. The CDT 2019 Coding Companion is just the tool. Newly revised and updated for 2019, the Companion trains staff to code more accurately and efficiently, with key coding concepts, scenarios, and Q&A. Use it with the CDT manual to train new staff or as a refresher for experienced team members. The Companion includes: • 100 coding scenarios • 175 common coding Q&A • Descriptions of new CDT Codes and revisions • Section on ICD-10 Diagnosis Codes The ADA’s Council on Dental Benefit Programs oversaw the development of the Companion to ensure the information is as precise and up-to-date as possible. Organized by coding category, each chapter was written by a dental expert, including coding consultants, insurance administrators and practicing dentists. J449BT CDT Companion Book + e-Book, 320 pages Members $49.95 Retail $74.95 Book ISBN# 978-1-68447-032-7 | e-Book ISBN# 978-1-68447-033-4 NEW CDT 2019: Dental Procedure Codes CDT 2019: Dental Procedure Codes is an essential tool for any dental practice. We all know how important it is to use accurate CDT Codes to avoid rejected claims. But this documentation may also protect practitioners if questions arise about treatment rendered. Since each code consistently records a service that was delivered, practitioners can build a thorough history of patient visits and treatment plans. The most up-to-date coding resource and the only HIPAA-recognized code set for dentistry, CDT 2019 Codes went into effect on January 1, 2019. Code changes include: • 15 new codes • 5 revised codes • 4 deleted codes CDT 2019 contains new and revised codes concerning: • Delivery of non-opioid drugs for pain management • Use of translation services • Measuring and documenting glucose levels just prior to a procedure J019BT CDT Book + e-Book, 172 pages | Members $54.95 Retail $82.50 J019i CDT Code Check App for iOS and Android | Members $19.95 Retail $29.95 J019BTi CDT Book + e-Book + App | Members $64.95 Retail $97.45 Book ISBN# 978-1-68447-030-3 | e-Book ISBN# 978-1-68447-031-0 Are you an ADA member with CDT questions? Call the ADA and ask to speak with a coding expert as part of your member benefits. CDT 2019 Coding Companion: Help Guide for the Dental Team 135 Chapter 5. D4000 – D4999 Periodontics 2 CODING SCENARIO #7 Overdue Patient with Gingivitis A patient of record in the office has not been seen for over two years. When they arrive for a routine prophylaxis, the evaluation reveals heavy plaque, some supra- and sub-gingival calculus, with moderate stain. Bleeding on probing is noted on most teeth accompanied by edema and swelling. No bone loss is seen on bitewing radiographs that are taken. From the clinical evaluation, a diagnosis of generalized moderate to severe gingivitis is made. The hygienist proceeds with a full mouth scaling treatment, not a prophylaxis, noting that this scaling procedure requires more time than needed for a prophylaxis. How should this appointment be coded for reimbursement? Since the patient has not been seen in the office for over a year, a comprehensive evaluation should be done. This includes both dental and periodontal charting, with pocket depths, bleeding points, and any additional findings such as suppuration and edema. D0150 comprehensive oral evaluation-new or established patientbe or D0180 comprehensive periodontal evaluation-new or established patient As mentioned, bitewing radiographs were also taken. D0274 bitewings – four radiographic images It is recommended that patients have a panoramic radiograph or full mouth radiographs every five years. If this patient does not have either in the last five years, then most likely a panoramic radiograph would also be taken. D0330 panoramic radiographic imagePlacement Diagnostic © 2019 American Dental Association 19 Restorative 1 Code on Dental Procedures and Nomenclature D2000-D2999 III. Restorative Local anesthesia is usually considered to be part of Restorative procedures. Explanation of Restorations Location Number of Surfaces Characteristics Anterior 1 Placed on one of the following five surface classifications – Mesial, Distal, Incisal, Lingual, or Facial (or Labial). 2 Placed, without interruption, on two of the five surface classifications – e.g., Mesial-Lingual. 3 Placed, without interruption, on three of the five surface classifications – e.g., Lingual-Mesial-Facial (or Labial). 4 or more Placed, without interruption, on four or more of the five surface classifications – e.g., Mesial-Incisal-Lingual-Facial (or Labial). Posterior 1 Placed on one of the following five surface classifications – Mesial, Distal, Occlusal, Lingual, or Buccal. 2 Placed, without interruption, on two of the five surface classifications – e.g., Mesial-Occlusal. 3 Placed, without interruption, on three of the five surface classifications – e.g., Lingual-Occlusal-Distal. 4 or more Placed, without interruption, on four or more of the five surface classifications – e.g., Mesial-Occlusal-Lingual-Distal. Note: Tooth surfaces are reported on the HIPAA standard electronic dental transaction and the ADA Dental Claim Form using the letters in the following table. Surface Code Buccal B Distal D Facial (or Labial) F Incisal I Lingual L Mesial M Occlusal O Diagnostic © 2019 American Dental Association 33 Periodontics 1 Code on Dental Procedures and Nomenclature D4000-D4999 V. Periodontics Local anesthesia is usually considered to be part of Periodontal procedures. Surgical Services (Including Usual Postoperative Care) Site: A term used to describe a single area, position, or locus. The word “site” is frequently used to indicate an area of soft tissue recession on a single tooth or an osseous defect adjacent to a single tooth also used to indicate soft tissue defects and/or osseous defects in edentulous tooth positions. – If two contiguous teeth have areas of soft tissue recession, each area of recession is a single site. – If two contiguous teeth have adjacent but separate osseous defects, each defect is a single site. – If two contiguous teeth have a communicating interproximal osseous defect, it should be considered a single site. – All non-communicating osseous defects are single sites. – All edentulous non-contiguous tooth positions are single sites. – Depending on the dimensions of the defect, up to two contiguous edentulous tooth positions may be considered a single site. Tooth Bounded Space: A space created by one or more missing teeth that has a tooth on each side. D4210 gingivectomy or gingivoplasty – four or more contiguous teeth or tooth bounded spaces per quadrant It is performed to eliminate 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 It is performed to eliminate suprabony pockets or to restore normal architecture when gingival enlargements or asymmetrical or unaesthetic topography is evident with normal bony configuration. Updated with 35 new scenarios! Now includes free e-Book when you order directly from ADA Catalog! 168 CDT 2019 Coding Companion: Help Guide for the Dental Team Basic Implant This image illustrates all components of a single implant. Please note that the connecting element (abutment) may not be present in all cases. The dentist’s clinical decision-making determines whether the implant crown will be supported and retained by an intermediary abutment, or if it may placed directly on the implant body. Implant Fixture/Body/Post The two most common types of implant posts are endosteal and mini implants. The size and type of implant fixture determines the proper code to document the surgical implant placement procedure. Surgical of an Implant Body: Endosteal Implant (D6010) : Placement of full-sized implant fixture into the jawbone. Surgical Placement of Mini-Implant (D6013) : Placement of mini-implant fixture into the jawbone. These are smaller in diameter than full-sized implants, yet are still considered permanent. Typically used to support removable prostheses. Key Definitions and Concepts Endosteal Implant Post/Body/Fixture Mini-Implant Post/Body/Fixture Images courtesy of Glidewell Laboratories Image courtesy of Glidewell Laboratories Implant Crown Abutment “Connecting Element” Implant Post/ Body/Fixture TABLE OF CONTENTS SECTION 1 – THE CDT CODE: WHAT IT IS AND HOW TO USE IT SECTION 2 – USING THE CDT CODE: DEFINITIONS AND KEY CONCEPTS, CODING SCENARIOS AND CODING Q&A 1 Diagnostic Ralph A. Cooley, D.D.S. 2 Preventive Paul Reggiardo, D.D.S. 3 Restorative Fred Horowitz, D.M.D. 4 Endodontics Kenneth Wiltbank, D.D.S. 5 Periodontics Marie Schweinebraten, D.M.D. 6 Prosthodontics, removable Terry Kelly, D.M.D. 7 Maxillofacial Prosthetics Terri Bradley 8 Implant Services Linda Vidone, D.M.D. 9 Prosthodontics, fixed Teresa Duncan, M.S. 10 Oral and Maxillofacial Surgery James Mercer, D.D.S. 11 Orthodontics Stephen Robirds, D.D.S. 12 Adjunctive General Services Charles Stewart, D.M.D. 13 Best Coding Practices ADA staff SECTION 3 — APPENDICES 1 CDT Code to ICD (Diagnosis) Code Cross-Walk 2 A Guide to Reporting D4346 3 ADA Guide to Dental Procedures Reported with Area of the Oral Cavity on Tooth Anatomy (or both) Numeric Index by CDT Code CODING AND COMPLIANCE 6 ORDER BY PHONE: 800.947.4746 CODING ORDER ONLINE: ADACATALOG.ORG 7 CODING AND COMPLIANCE