Dental Billing

Underused CDT Codes To Increase Your Practice Profits Today

February 16, 2024

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I'm Amanda — Founder of Essential Dental Services. I've immersed myself in the world of dentistry for nearly two decades.

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The top underused CDT codes to increase your practice profits are pretty straightforward, so don’t worry! Every detail counts when it comes to managing a successful dental practice – and knowing the right codes can make all the difference, especially when revenue discussions are on the table. Current Dental Terminology (CDT codes) may seem like mere technicalities, but their strategic deployment is akin to the focused beam of a curing light – powerful, directed, and absolutely vital for the task at hand.

In the world of dental billing, underused CDT codes represent untapped streams of revenue. It’s time to put the spotlight on four such codes that, when wielded with intent, have the potential to boost your practice’s financial health considerably. Let’s drill into these under appreciated digits and uncover the ways in which they can transform the bottom line of your practice.

1.) D1206 and D1208 Fluoride Treatments

While most offices perform fluoride treatments on children and teenagers, adults are often overlooked due to outdated insurance rules. When beginning to work with several practices, we noticed they would write-off the fee for fluoride treatment for adults. They were under the assumption insurance would not pay for this benefit but more and more dental insurance plans are! This is a great CDT code to be checking eligibility for when performing your insurance verifications! Patients who have an insurance plan that does not cover fluoride treatment for adults should still be offered the service!

2. D9110 Palliative (Emergency) Treatment of Dental Pain

During emergency visits plagued by pain, many default to the D0140 code. This evaluation code is subject to limitations like “one evaluation per six months”. However, D9110 shines in its focus—it is designated for minor, non-definitive treatments aimed at easing discomfort, sensitivity, or pain. D9110 falls outside of the constraints applied to exams, ensuring that your patient’s emergency doesn’t count against their evaluation quota. Moreover, D9110 often commands a higher UCR compared to D0140, tipping the scales in favor of more favorable reimbursement. Be diligent in documenting a narrative to underpin the use of D9110. This code should not be combined with definitive procedures in the same visit. As with any code, verify its eligibility during insurance checks, as coverage can differ by insurer and policy.

3. D0180: Comprehensive Periodontal Evaluation– New or Established Patient

The code D0180 may be reported for established periodontal patients, patients showing signs or symptoms of periodontal disease, and for patients with risk factors such as smoking and diabetes. This comprehensive periodontal evaluation entails a meticulous examination with full-mouth probing and extensive charting. Due to the thoroughness of this procedure, which evaluates and documents probing and documentation of various periodontal health indicators like gum recession, tooth mobility, and the presence of exudate, the code often justifies a correspondingly higher fee.

4. D0460: Pulp Vitality Tests

During patient visits involving complaints of toothache, a common step undertaken by clinicians is the administration of a pulp vitality test. This is usually assigned procedure code D0460, to determine the appropriate course of treatment. Despite this, many dental practices fail to bill for this distinct procedure, mistakenly bundled as “part of the exam.” It is crucial to recognize that D0460 stands as a billable entity. It should be a standard practice to ensure proper insurance reimbursement for the diagnostic efforts provided.

The Verdict: Charting a Course Towards Optimized Billing

CDT codes may be the small print, but they have big implications for your practice’s financial performance. As practices navigate the intricacies of revenue management, staying abreast of CDT codes’ dynamic landscape is critical. Here at Essential Dental Services, we talk bout the importance of insurance verifications a lot. However, this is the best way to know if the mentioned CDT codes are covered or what the plan limitations may be. Our CEO Amanda DeMoura has a wonderful article on the importance of insurance verifications, be sure to check that out! We’ve just sketched the surface of what’s possible. It’s up to your practice to harness these insights and chart a course towards billing optimization! Looking for even more ways to boost profit? Check out our podcast episode on this!

Amanda DeMoura and Sarah Hamlin deliver a podcast dedicated to helping dental professionals navigate the intricacies of running a successful dental practice. Whether you're a seasoned practice owner, new dentist, or a dental professional looking to enhance your managerial skills, this podcast is your go-to resource for valuable insights, expert advice, and actionable strategies.

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