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CDT 2020 Changes Are Here!

As of January 1, 2020 the American Dental Association’s (ADA’s) procedure code changes will be in effect. There are also associated changes to Northeast Delta Dental policies that also will be effective January 1, 2020. There 37 new codes, 20 revisions to existing codes and six (6) deleted codes that have been replaced by several of the new codes. Many of the new codes and revised codes further define existing procedures by quadrant, arch or materials. There are no changes to their related standard processing policies.

Please be sure not to submit claims for the new codes with dates of service prior to January 1, 2020, and please don’t submit claims for the deleted codes on or after January 1, 2020. Your claims will be returned to your office for resubmission with the correct codes for the dates of service involved. This will unnecessarily delay processing of your claims.

New Codes and Standard Delta Dental Processing Policies:

Covered once every 3 years

  • D0419 - assessment of salivary flow by measurement

Covered once per appliance – replacing D1550 - re-cement or re-bond space maintainer:

  • D1551 - re-cement or re-bond bilateral space maintainer – maxillary
  • D1552 - re-cement or re-bond bilateral space maintainer – mandibular
  • D1553 - re-cement or re-bond unilateral space maintainer – per quadrant

Not covered/not billable to the patient – replacing D1555 – removal of fixed space maintainer:

  • D1556 - removal of fixed unilateral space maintainer – per quadrant
  • D1557 - removal of fixed bilateral space maintainer – maxillary
  • D1558 - removal of fixed bilateral space maintainer – mandibular

Covered once per tooth every 7 years:

  • D2753 - crown - titanium or titanium alloys

Covered once per quadrant every 7 years:

  • D5284 - removable unilateral partial denture – one piece flexible base (including clasps and teeth) – per quadrant
  • D5286 - removable unilateral partial denture – one piece resin (including clasps and teeth) – per quadrant

Covered once per tooth space every 7 years

  • D6082 - implant supported crown - porcelain fused to predominantly base alloys
  • D6083 - implant supported crown - porcelain fused to noble alloys
  • D6084 - implant supported crown - porcelain fused to titanium or titanium alloys
  • D6086 - implant supported crown - predominantly base alloys
  • D6087 - implant supported crown - noble alloys
  • D6088 - implant supported crown - titanium/titanium alloys
  • D6120 - implant supported retainer – porcelain fused to titanium and titanium alloys
  • D6121 - implant supported retainer for metal FPD – predominantly base alloys
  • D6123 - implant supported retainer for metal FPD – titanium and titanium alloys
  • D6195 - abutment supported retainer - porcelain fused to titanium and titanium alloys
  • D6243 - pontic - porcelain fused to titanium and titanium alloys

Covered once per tooth every 7 years:

  • D6753 - retainer crown - porcelain fused to titanium and titanium alloys
  • D6784 - retainer crown ¾ - titanium and titanium alloys

Not covered/not billable to the patient:

  • D7922 - placement of intra-socket biological dressing to aid in hemostasis or clot stabilization, per site

Not covered/billable to the patient – replacing D8691, repair of orthodontic appliance:

  • D8696 - repair of orthodontic appliance – maxillary
  • D8697 - repair of orthodontic appliance – mandibular

Not covered/not billable to the patient – replacing D8693, re-cement/re-bond fixed retainer:

  • D8698 - re-cement or re-bond fixed retainer – maxillary
  • D8699 - re-cement or re-bond fixed retainer – mandibular

Not covered/not billable to the patient – replacing D8694, repair of fixed retainer:

  • D8701 - repair of fixed retainer, includes reattachment – maxillary
  • D8702 - repair of fixed retainer, includes reattachment – mandibular

Not covered/billable to the patient – replacing D8692, replace/lost/broken retainer:

  • Replacement of lost/broken retainer – maxillary
  • Replacement of lost/broken retainer – mandibular

Not covered/not billable to the patient:

  • D9997 - dental case management – patients with special health care needs

Existing Codes with New Standard Delta Dental Processing Policies:

Was given an alternate benefit of D0150, comprehensive evaluation. As of January 1, 2020 will be covered as submitted and counts toward evaluation benefit:

  • D0160 – Detailed and extensive oral evaluation - problem focused, by report

Was not covered/billable to the patient. As of January, 1, 2020, will be covered once every 24 months for patients 18 years old and younger:

  • D9941 – athletic mouthguard

If you have any questions, please feel free to contact Eleanor Vien, Director of Professional Relations at 603-223-1305 or by email to evien@nedelta.com