October is National Dental Hygiene Month, a great time to take a look at dental coding. For coders who assign ICD-10 codes, our first thought may be of those codes found at range K00-K08. As Coding Clinic from the fourth quarter of 2016 reminds us, there was an expansion of dental codes in ICD-10 in 2016, which included 22 new codes. It also noted that prior to that, diagnostic codes weren’t widely used in dentistry. However, due to some state Medicaid requirements, ICD-10 code assignment became necessary. The ADA (American Dental Association) notes that ICD-10-CM codes also help facilitate claim payment and coverage.
We are familiar with ICD-10 and CPT®, but did you know the ADA publishes and maintains a code set specifically for dental coding? Current Dental Terminology (CDT) is the specific code set for reporting dental procedures. There are about 800 CDT codes currently. CDT will update on Jan. 1, 2026 (just like CPT!) with 31 new codes, six deletions, and 14 revisions. The ADA has a process similar to what we recently reviewed with our ICD-10 updates. They have a Council on Dental Practice (CDBP) that established a Code Maintenance Committee (CMC). The CMC reviews requests for code changes, ensuring all stakeholders have a voice – sound familiar?
The CDT code set is divided into chapters – again, similar to which we are familiar. There are 12 chapters of codes, based on the type of dental service provided:
Diagnostic;
Preventive;
Restorative;
Endodontics;
Periodontics;
Prosthodontics;
Oral and Maxillofacial Surgery;
Orthodontics;
Adjunctive General Services;
Anesthesia;
Adjunctive Services; and
Imaging.
The CDT codes themselves are five characters long. They are alphanumeric, all starting with the letter D followed by 4 numbers. CDT is the Health Insurance Portability and Accountability Act (HIPAA) standard for coding and reporting dental procedures.
Coding professionals who work in the dental world have their own credentials and organization as well. The American Dental Coders Association was founded in 2006 to represent professionals in dental coding. They have two certificate programs that offer credentials in the field: the Certified Dental Coder (CDC) and the Certified Dental Billing Specialist (CDBS). You must be a member of the ADCA in order to take either certification exam. In addition, to become a CDC, you must also have two years of experience or complete an online course. Membership to ADCA includes access to Ask-the-Coder, a knowledge base whereby coders can submit questions on real-world coding scenarios.
The ADCA website references U.S. Bureau of Labor statistics and national employment forecasts noting that jobs in healthcare billing and coding across the board are projected to increase by 8 percent through 2032. The ADCA further notes the expansion of services by dental practices, tighter regulatory oversight, and an increase in tele-dentistry as forces supporting the increased need for certified dental coders. Regardless of where they practice, coding professionals will continue to be vital members of the healthcare team.
Clinical documentation integrity (CDI) professionals work in a variety of settings, and although I mostly focus on topics related to hospital inpatient billing, this week
This past weekend we “fell back” and gained that extra hour. This makes it a good time to look at how we assign codes for
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