The submitted amount is not payable by delta dental, but is collectable from the patient. Please use cdt 2020 codes when submitting claims to delta dental for services. Code maintenance committee cmc american dental association. There are 35 new codes, 37 revised codes, 12 deleted codes and 7 changes to subcategories. The 2019 version of the cdt code includes 15 new procedure codes and 6 deleted codes. Prophylaxis and root planing codes and billing guidelines. Use cdt 20 on claims beginning in january delta dental. Delta dental recognizes the american dental associations cdt 20 as the standard code set for all dental claims. Updates dentist delta dental of kansas delta dental. The attached dental procedure codes appendix lists.
All procedure codes being deleted from the national code set will be eliminated from use for dates of service on or after october 1, 2003. Such updated codes, descriptors and nomenclature may be used to describe these covered procedures in compliance with federal. Code maintenance committee cmc cdbp established its code maintenance committee to ensure that all stakeholders have an active role in evaluating and voting on cdt code changes. This information is to be used only as a general guideline in determining benefits under the new codes. This guide includes all endodontic cdt codes and frequently used nonendodontic codes.
Please be sure to use these codes on claims submitted to delta dental for services your office provides on and after january 1, 20. Ada cdt 2020 hipaa requires all services rendered as of january 1, 2020 must be submitted using the new ada cdt 2020 codes. One use of the cdt code is to provide for the efficient processing of dental claims, and another is to populate an electronic health record. The american dental association may periodically change cdt codes ordefinitions.
Supplemental dental codes list the following list of preventive and comprehensive dental codes is effective as of 01012019. However, some medical carriers may direct that you use cdt codes on a cms 1500 form for dental procedures which do not have an applicable cpt code e. December 11, 2019 this list of codes applies to the policy titled dental services. Federal hipaa law requires that cdt codes be used in electronic health care transactions. If you are shopping for individual dental insurance, have individual dental insurance or have general questions, enter the state you live in. Cdt procedure code information this section provides processing policies and procedures for the american dental associations new cdt codes. On january 1, 20, ods alaska will implement the new codes that the american dental association ada has outlined in cdt. New space maintainer codes d1516 and d1517 to define each arch replaces deleted code d1515. The national network of delta dental companies protects more smiles than any other insurance company.
Cdt 20 is the reference manual published by the american dental association ada that contains the code on dental procedures and nomenclature cdt code. Current dental terminology changes and processing policy. If the fee for a procedure or service is disallowed, it is not benefited by delta dental nor collectable from the patient by a participating dentist. This version of the cdt code is effective for services provided on or after january 1, 20. Participating dentists can access the updated delta dental dentist handbook online through the delta dental plans association ddpa portal. Dental procedure medical billing and coding forum aapc. There are no changes to the 2020 delta dental premier nor the delta dental ppo fee schedules with the exception of these 3 procedure codes. Enter your user name and password or register if you are a new ddpa site user. Cdt codes are ed by the american dental association. Through our community efforts, delta dental is able to help millions of americans each year by improving oral health education and access, supporting local services and programs, and expanding dental care. Summary of cdt 2018 changes cdt 2018 is the newest version of the american dental associations code on dental procedures and nomenclature. In general, cpt codes are not used on ada forms, and cdt codes are not used on cms 1500 medical forms. As you have previously been informed, several enhancements were introduced designed to benefit ddks members your patients that will become effective upon employer group renewal.
We would like to show you a description here but the site wont allow us. It is the policy of delta dental to comply with all such. American dental association cdt 2017 code on dental procedures and nomenclature effective january 1, 2017 d0120 periodic oral evaluation established patient d0140 limited oral evaluation problem focused d0145 oral evaluation for a patient under three years of age and counseling with primary caregiver. Cdt 20 dental procedures and codes the cdt 20 is now available to assist you and your staff with coding skills and to help you accurately document and report services delivered to your patients. Delta dental of washington cdt 20 code change summary new codes effective 11 20 code nomenclature delta dental usa policy d0190 screening of a patient covered with limitations d0191 assessment of a patient covered with limitations d0364 cone beam ct capture and interpretation with limited field of view less than one whole jaw not a covered benefit. Diagnostic dentist handbook january 2020 cdt ada cdt nomenclature ada cdt descriptor delta dental policy code d0140 limited oral evaluation an evaluation limited to a the frequency limitation for evaluations is problem focused specific oral health problem or established by groupindividual contract. These national processing policies have been revised to reflect data code set requirements set forth under the administrative simplification provisions of the health insurance portability and accountability act of 1996 hipaa and related regulations. The following list shows all codes covered for plans in the state of california. Cdt code lookup the american dental associations code on dental procedures and nomenclature cdt is used to record and report dental procedures.
The american dental association may periodically change cdt codes or definitions. The following changes will be effective for ddok standard groups. Offices must use the most current version of cdt when filing claims. Resort september 1721, 20 on behalf of delta dental of virginia and smart smiles. The purpose of the cdt code is to achieve uniformity, consistency and specificity in accurately documenting dental treatment. Any claims with dates of service prior to january 1, 2020 should be submitted using appropriate ada cdt codes. Tools, resources, links, and a variety of information on evidencebased dentistry. Accurate recording and reporting dental treatment is supported by a set of codes that have a consistent format and are at the appropriate level of specificity to adequately encompass commonly accepted dental procedures. Practices occasionally file medical claims for endodontic services and guidance is included for crosscoding dental claims to medical claims using icd10 and cpt codes. In those situations, they may also request use of cdt anesthesia codes. List cdt procedure code s submitted on the electronic claim. The charts below show how the ods alaska standard contract will cover these new cdt codes. Applicable codes this list of procedure andor diagnosis codes is provided for reference purposes only and may not be all inclusive.
Any new cdt 4 procedure code not listed will not be covered at this time. On august 17, 2000 the cdt code was named as a hipaa standard code set. Such updated codes, descriptors and nomenclature may be used to describe these covered procedures in compliance with federal legislation. The american dental association has published the new procedure codes for 2019. D52 preventive resin restoration in a moderate to high caries risk patient permane d2140 amalgamone surface, primary or permanent d2150 amalgamtwo surfaces, primary or permanent d2160 amalgamthree surfaces, primary or permanent d2161 amalgamfour or more surfaces, primary or permanent d2330 resinone surface, anterior d2331. Name and phone number of who to contact if there are questions regarding attachments.
Listed below are the cdt 4 procedure codes adopted by the dch for dental services. Delta dental of nebraska procedure codes requiring attachments. Effective january 1, 2018, the american dental association ada has added 18 new codes and deleted three codes in the code on dental procedures and nomenclature cdt. When the ada changes the codes, carriers must adopt the changes.
To order cdt 2019 items, visit or contact the ada at 800. For 2020, there were over 156 code change requests and of those, 37 new codes, 5 revised codes and 6 deleted codes will be added to cdt 2020 dental procedure codes. We greatly appreciate the care you provide each and every day to patients enrolled in delta dental s many programs, especially those administered by the federal government programs division of delta dental of california. Any dental claim submitted electronically or paper must use procedure codes from the current version of the cdt code. Cdt 2020 is the newest version of the american dental associations code on dental procedures and nomenclature. Wed like to focus on several key changes that may impact your claim submissions to. At delta dental, our mission is to put a happier, healthier smile on every americans face by providing greater access to oral health care.
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