Are you prepared for CDT 2022?

Current Dental Terminology (CDT) is the standardized procedure code set for dentists to document what they do. Additionally, CDT is the code set used to report procedures to dental payers seeking reimbursement from a benefit plan. CDT codes are reviewed annually by the Code Maintenance Committee (CMC). CMC is tasked with providing dentists with the most accurate codes to report procedures rendered.  

The CDT becomes effective January 1 of each calendar year. Coding guidelines are that dentists document and report procedures using codes from the code set current at the time of service. For CDT 2022, there are 16 new, 14 revised, and 6 deleted codes. That may not seem like a lot of changes however, just one change can impact your practice.  

One of the ways it can impact your practice is denied claims, resulting in delayed reimbursement from payers. We all want to be paid promptly for services rendered! One of the most important impacts is inaccurate documentation of procedures rendered. The deletion of one word from a code nomenclature or descriptor can change how the procedure is utilized in your practice and is documented. Having assisted thousands of dental team members in solving coding and insurance related challenges over the past 8 years of my career, I have found that specificity in documentation is what is lacking.  

Let’s look at one revision for CDT 2022.  

D0120 periodic oral evaluation – established patient 

An evaluation performed on a patient of record to determine any changes in the patient’s dental and medical health status since a previous comprehensive or periodic evaluation. This includes an oral cancer evaluation, periodontal screening where indicated, and may require interpretation of  information acquired through additional diagnostic procedure. The findings are discussed with the patient. Report additional diagnostic procedures separately.  

The addition of the sentence “The findings are discussed with the patient” has made it clear reviewing the findings with the patient is part of the procedure. This sentence adds the need to ensure not only that the evaluation findings or lack thereof are documented but the documentation should indicate the findings were reviewed with the patient and any related conversation with the patient is documented. Your documentation needs to be specific while telling the story of each patient encounter.  

So, what does it mean to be prepared for CDT 2022? 

First step is to order a CDT book each year. In addition, consider ordering the ADA CDT 2022 Coding Companion as this is a valuable resource in understanding the intended use of codes.  

Prior to January 1 of each year, clean up your codes entered in your computer software, inactivating deleted codes. The use of a deleted code delays payment. Ensure that all new codes have been entered and where applicable update the nomenclature to reflect any changes.  

The most important step is schedule a time to train your entire team either before the code set becomes effective or shortly thereafter. I am often asked why I recommend training as a team. As shown in the example of D0120, it is about documentation, ensuring quality patient care. Everyone in the practice who has any part in the patient encounter needs to understand the documentation requirements. The business team sending claims to an insurance payer is not the only person who needs to become aware of code changes. We all have a part in documenting the patient encounter. Specificity in documentation is key! 

And don’t forget to prepare for 2022 patient insurance changes. Request a consultation with Unified Smiles and receive our dental benefits verification form – at no charge!  Prepare for 2022 patient insurance changes. Schedule now and receive our dental benefits verification form.