Dental CPT Codes

Dental CPT codes are often referred to as Level I codes and used to report procedures to medical payers for dental works. This code set is maintained by the American Medical Association.

Submitting Dental Claim Form

It is important to follow the dental claim form instructions exactly when submitting a medical claim. Common claim form errors include, but are not limited to, the use of punctuation, the absence of a description when reporting an unlisted CPT code, and use of the appropriate modifier or qualifier, when required. So we try to list dental CPT codes with one by one with descriptions because It is important for dentists to invest in staff training and resources to ensure accurate completion of any claim form to all third parties.


icd10-medical-billing-usage

ICD-10 Code Usage

Some commercial payers, based on the plan design, may require ICD-10 diagnostic codes in order to adjudicate the claim correctly.

Payers need to define when and under what circumstances, providers will need to submit diagnosis codes.

Common interpretation of when provider diagnosis codes will be required for submission is when patients have enhanced benefit coverage for dental services due to oral health risks associated with certain systemic health conditions.

Common ICD-10 Codes For Dentists

K08.21-K08.26 - Atrophy
K08.0 - Exfoliation of Teeth Due to Systemic Causes
K05.32 - Chronic Periodontitis, Generalized
K05.00 - Acute Gingivitis
K05.10 - Chronic Gingivitis
K06.01 - Gingival Recession, Localized
K06.02 - Gingival Recession, Generalized
-- K12.2 - Cellulitis and Abscess of Mouth
K04.6 - K04.7 - Periapical Abscess
K00.6 - Disturbances in Tooth Eruption
K01.1 - Impacted Teeth
M26.31 - Crowding of Fully Erupted Teeth
K06.3 - Horizontal Alveolar Bone Loss


Anatomy Of An ICD-10 Code

1 2 3 4 5 6 7
Section Body System Root Operation Body Part Approach Device Qualifier
  1. Section relates to type of procedure
  2. Body system refer to general body system
  3. Root operation specifies objective of procedure
  4. Body part refers to specific part of body system on which procedure is being performed
  5. Approach is the technique used to reach the site of the procedure
  6. Device specifies devices that remain after procedure is completed
  7. Qualifier provides additional information about procedure

CDT Code Range For Dental Terminology

DiagnosticD0100-D0999
PreventiveD1000-D1999
RestorativeD2000-D2999
EndodonticsD3000-D3999
PeriodonticsD4000-D4999
Prosthodontics, RemovableD5000-D5899
Maxillofacial ProstheticsD5900-D5999
Implant ServicesD6000-D6199
Prosthodontics, FixedD6200-D6999
Oral & Maxillofacial SurgeryD7000-D7999
OrthodonticsD8000-D8999
Adjunctive General ServicesD9000-D9999
Check Dental Codes:

Current Dental Terminology (CDT) codes are procedure codes created by the American Dental Association (ADA) to achieve uniformity, consistency, and preciseness in accurately documenting dental treatment. CDT codes are not made for the insurance companies; rather, for accuracy and consistency in dental documentation.

CDT Procedure Code List

Most Expensive Dental Procedures With CDT Codes

Dental Bridges: Start at $3000

You may require dental bridges if you are experiencing tooth loss. The cost for dental bridges can vary and depends on how many teeth are involved in your treatment plan.

CDT Codes:

D0232

D2201

D2300

D2301

D3310

Dental Implants: $1000 - $2000

Dental implants are fixed in place and a permanent tooth replacement option. Fashioned from titanium, these artificial tooth roots are surgically inserted into your jawbone and then hold a replacement tooth, or dental crown.

CDT Codes:

D4420

D4421

D4422

D4423

Dental Crown/Abutment: $2500 - $4000

The cost varies widely for dental implants and crowns/abutments as the price is dependent on the type of implant, graphing, and restorative materials used in your unique case.

CDT Codes:

D0095

D0099

Dental Crowns, Inlays or Onlays: $1000 - $2500

If you have a dental implant, a broken tooth, a severely decayed tooth, or other dental restoration options such as tooth fillings aren't possible, your dentist may recommend a dental crown, inlay or onlay.

CDT Codes:

D5001

D5003

D5005

D9900

Clear Correct Cost: $3500 - $6000

Clear Correct clear braces are a wonderful option for patients who want to straighten their teeth in an inconspicuous manner. Clear Correct treatment uses a series of custom-fitted aligner trays to straighten upper and lower teeth just like regular braces - but without metal brackets or wires.

CDT Codes:

D0132

D0133

D0134

D0135

D0136

D0137

D0138

D0139

Dentist Problems In Billing Forms With Patients

Common questions & answers with patients insurance collections and dental benefits plans.

What can I do if a patient refuses to pay for what insurance won't cover ?
When the parents are divorced, who should pay for a child's treatment ?
Is it reasonable to check my patient's credit history before I start treatment ?
Can I charge interest for late payments ? If I do so, am I required to notify patients before I start charging interest ?
What notices am I legally required to provide patients to whom I offer third-party financing ?
What if the patient doesn't return for completion of the treatment and the dental plan has already paid for it ?
Can I offer a discount to my patients who pay in full prior to treatment ?
Are there legal problems in giving discounts to family, staff or colleagues ?
If a patient is behind on payments, can I withhold records or stop treatment ?
How do I collect an unpaid balance if the patient is in bankruptcy ?
A patient is owed a refund from overpayment, but I cannot locate the patient to send the refund. What do I do with the funds ?
What do I need to know about working with a collection agency ?
What are the federal and state laws that apply to my collection efforts ?
Is there a statute of limitations for collecting debt ?
Is small claims court an option for collecting unpaid bills ?
What should I do if a patient isn’t satisfied with the quality of treatment and wants a refund ?
Should I use the fee allowed by the plan for each procedure or my own usual, customary and reasonable (UCR) fee ?
Can I waive patient copays ?
Can I establish a discount program in my practice for patients, and what are the legal requirements ?
How soon must I submit a claim in order for it to be considered valid ?
How soon must a dental plan or insurer pay submitted claims ?
What options do I have if I disagree with the insurance plan's payment decision ?
A dental plan is auditing my practice - what does this mean ?
Does an auditor have the authority to access patient records ?
How can a dental office prepare for an announced audit ?
What if the office fails the dental audit?
Are plans required to pay for in-hospital dental treatment ?
Does obtaining a prior authorization from a patient's plan obligate the plan to pay for that treatment ?
Can lab costs be charged on a claim separately from a procedure ?
Must refund demands from dental plans always be paid ?
What should I be aware of when considering contracting with a plan to join its provider network ?
Can I balance bill a Denti-Cal beneficiary for the portion of my bill that wasn't paid by Denti-Cal ?
May I charge a Denti-Cal patient for an alternative procedure that is not a covered benefit of Denti-Cal ?
Must an associate dentist in my office be separately enrolled as a Denti-Cal provider if I am enrolled as a provider ?
What is the best way to obtain information about the treatment, provider participation and payment policies of the Denti-Cal program ?
How and when your practice verifies patient insurance coverage ?
What medical plans will pay for in dental operations ?

Dental Insurance Terms

terms

View all dental terminalogy in dental billing claim form. Know how to write it.

Importance Of CPT Dental Code Usage

It is critical that the billing staff continually update their knowledge of billing codes, especially now that HIPAA regulations have been implemented, requiring all offices and insurance companies to use only current Dental CPT codes in filing and processing claims electronically. It is also imperative, unless an extension was filed, that these codes were incorporated into the billing protocol for all claims.

Dental CPT Code Lookup.

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