In Part 1 of the trending technologies for 2025 article, we explored technology and patients' reception of newer ways to do dentistry and to see better results specific to their needs. In Part 2, we explore the new ADA Code on Dental Procedures and Nomenclature (CDT) codes that are being introduced in January 2025 and how to apply them to patient treatment and ensure that procedures are billed correctly. Adding, deleting, or revising codes always affects procedures and services delivered to patients and the method of justifying and billing the services to the many insurance plans of patients.
Estela Vargas, CRDH.
Each dental plan will pay for the coded procedures according to in-network contracts and out-of-network policies. Therefore, including insurance estimates in patients' treatment planning is imperative.
Some insurance plans keep up with technological changes, but others take a while to catch up. This should never affect the best care that you can give to patients.
If a procedure is not a covered benefit of the patient's plan, they need to know if it is billable to them or not according to the contract. Coding updated technology and procedures ensures that robust and accurate patient records are created.
If there is any lapse in memory for either the patient or the dentist, accurate records are insurance against misunderstandings. Remember that some dental procedures are covered under a patient's medical policy. Often, the medical policy must be billed first. Perform insurance verification before presenting the estimate to patients.
Medicare will also cover more specialty services in 2025. I will cover this topic in a future article.
A thorough insurance verification process ensures that the patient understands and accepts where their dental plan starts and stops in payment for their care.
Every year, in March, the ADA's code maintenance committee meets to discuss and rule on suggested additions to new codes and deletions and revisions to existing codes. These suggested changes are due to new and improved technology and treatment modalities currently offered to patients.
CDT 2025, which goes into effect on January 1, 2025, includes 10 new codes, eight revisions, two deletions, and four editorial changes. The final designation for assigned coding numbers and terminology has yet to be finalized for all changes. What we do know is in the following remarks.
D2940 has a notable revision: the change of the nomenclature and descriptor to enable a single code to document the placement of an interim direct restoration.
Revisions to existing codes
Implant maintenance
Currently, there are only two procedure codes that can be used for implant maintenance (see CDT 2024, p. 57):
- D6080: Implant maintenance procedures when prostheses are removed and reinserted, including cleansing of prostheses and abutments.
- Descriptor: This procedure includes active debriding of the implant(s) and examination of all aspects of the implant system(s), including the occlusion and stability of the superstructure. The patient is instructed in thorough daily cleansing of the implant(s). This is not a per-implant code and it is indicated for an implant-supported fixed prosthesis.
- D6081: Scaling and debridement in the presence of inflammation or mucositis or a single implant, including cleansing of the implant surfaces, without flap entry and closure.
- Descriptor: This procedure is not performed in conjunction with D1110, D4910, or D4346.
Currently, there is one procedure code that can be used for the treatment of implant mucositis (see CDT 2024, p. 57). Coming in January 2025, the D6081 nomenclature is revised to the following:
- D6081: Scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding upon probing, and increased pocket depths. Includes cleaning the implant surfaces without flap entry and closure.
- Descriptor: This procedure is not performed in conjunction with D1110, D4910, or D4346.
Two new procedure codes: Dermal fillers and neuromodulators
There have been more advances in dental and medical technology during the past few years than in previous decades. Dermal fillers and neuromodulators are used both cosmetically and therapeutically in dentistry.
Each state has specifics regarding uses (cosmetic or therapeutic), education required, and who can administer them. The ADA offers continuing education courses for these procedures.
Coming in January 2025: Two new procedure codes with no descriptors
- D9914: Administration of dermal fillers
- Descriptor: None
- D9913: Administration of neuromodulators
In the U.S., dental providers in several states are now permitted to administer dermal fillers after completing approved training courses. This number is expected to increase over the next few years.
Patients must be fully aware of the risks of dermal filler injection and provide informed consent for this therapy. A thorough knowledge of anatomy, the properties of the available filling materials, and injection techniques is essential to prevent complications. It is also necessary to detect and manage complications early to mitigate untoward incidents and improve patient outcomes.
Other coding changes coming in January 2025
- D6180: Implant maintenance procedures when a full-arch fixed hybrid prosthesis is not removed, including cleansing of prostheses and abutments
- D6193: Replacement of implant screw
- D7252: Partial extraction for immediate implant placement
- D7259: Nerve dissection
- D8091: Comprehensive orthodontic treatment with orthognathic surgery
- D8671: Periodic orthodontic treatment visit associated with orthognathic surgery
- D0801: 3D intraoral surface scan‚ direct
- D6051: Placement of interim implant abutment
To be prepared for newer technology and billing the new and revised codes, you must be informed and educated to stay ahead of the pack. Update your software and coding books yearly, and outsource billing to experts who can manage the ever-complex job for you.
Editor's note: References are available upon request.
Estela Vargas, CRDH, is the founder and CEO of Remote Sourcing, a dental insurance billing and revenue recovery service. She is a graduate of Miami Dade College's dental hygiene program. Vargas' extensive background in the clinical arena of dentistry is coupled with her experience as a practice administrator and business executive.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
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