Focus on a New CDT Code

Expanding on this, if the CBCT machine has a special bitewing mode, it usually captures two exposures which give the same amount of information as four traditional bitewing images. That said, because it was only two actual exposures, you cannot bill out for a four-bitewing set (D0274) even though the data were equivalent. You must charge what you do, which was two bitewings, or a D0272. If you wish to charge for four bitewings, it is better to use sensors or film and take traditional images, leaving the CBCT BW mode only for gaggers or those who cannot tolerate the sensors.

Standards of care in dentistry are established by evidence-based review and continue to evolve. Reimbursement for the capture and/or interpretation of CBCT images is currently limited. As the appreciation and use of this technology increases and the patient benefit of the images captured are documented, the frequency and likelihood of reimbursement for CBCT imaging may increase in the future.

For more in depth instruction on medical coding, please reference our book Medical Dental Cross Coding with Confidence, available at www.practicebooster.com/store

D3921 Decoronation or submergence of an erupted tooth

Intentional removal of coronal tooth structure for preservation of the root and surrounding bone.

Rationale for adding D3921: The CMC approved this code submission by the American Association of Endodontists. The AAE requested this code to address a gap in CDT. The coronectomy code (D7251) is intended for use “when a neurovascular complication is likely if the entire impacted tooth is removed.” Its specific reference to impacted teeth and neurovascular complications restricts its use in other applications. The requested endodontic code will address the intentional removal of the coronal tooth structure when preserving the root to facilitate maintenance or continued development of the bone around ankylosed or fractured teeth. It also applies when an extraction is contraindicated due to a risk of osteonecrosis from radiation therapy or medications such as bisphosphonates. Coding scenario #1: A 12-year-old girl has a history of dental trauma and avulsion three years prior. A root canal was performed on #9 at the time, and the tooth now appears ankylosed on the radiographs. Decoronation is performed, removing the clinical crown, and the gutta percha is removed. The submergence allows continued development of bone around the remaining root until an implant can be placed at a later time. The root would need to be removed before the implant placement.

Coding scenario #2: A forty-year-old patient has a history of bisphosphonate use and there is a strong possibility of medication-related osteonecrosis. A decoronation is performed so that a portion of the tooth will remain in the mouth.