Mark Your Calendars: CDT Changes Town Hall on April 1, 2022
As you may know, the 2022 CDT changes went into effect in January of this year. The AAO, in order to assist members with coding issues that have arisen, will be hosting a 2022 CDT Changes Town Hall on April 1, 2022 at 12:00pm CT.
Register for the town hall and submit questions here.
AAO members who register for this town hall can submit CDT Coding questions that will be answered by Dr. Randall Markarian (AAO Council on Orthodontic Health Care), Dr. Steve Robirds (AAO Trustee), and Andrew Wiltsch (AAO Associate General Counsel). Formerly published FAQs, a code change checklist, and 2022 At-A-Glance Guide are also available below.
First announced by the AAO in July of 2021, changes to the ADA’s CDT 2022 go into effect January 1, 2022. With it comes changes to the orthodontics section of the Code (D8000-D8999) and other changes relevant to the practice of orthodontics.
The AAO has created member resources available at no cost to help you navigate these changes including:
- 2022 Code Changes FAQ
- Code Changes Practice Checklist
- AAO Recorded Webinar: Dental Coding and CDT 2022
- At-A-Glance Guide to CDT 2022
- Guide to Negotiating Network Provider Agreements
AAO Members can access further information and resources on coding and insurance claims by visiting the AAO website’s Insurance Claims page.
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When treating in two phases, should we submit Ph1 treatments as D8070 Comprehensive treatment of the Transitional Dentition, and Ph2 as D8080 Comp tx of Adolescent dentition?
In both phases of treatment the goal is comprehensive care. I would argue that Limited treatment codes should only be used on the patient that is not seeking comprehensive care. A Phase 1 and Phase 2 patient would fall under D8070 and D8080 respectively. Any thpoughts?
Hello Charles, I have a similar mindset when it comes to approaching Phase I care and have coded it under a comprehensive code in the past. To me, it is the first phase of an overall comprehensive plan. Each doctor needs to make these decisions and code for what they feel they are providing to the patient. If you look closely at the At a Glance Guide or the actual CDT manual, at the end of Dentition section it states “all of the following orthodontic treatment codes may be use more than once..” and further the last sentence of Comprehensive Orthodontic Treatment…”comprehensive orthodontics may incorporate treatment phases focusing on specific objectives at various stages of dentofacial development” In your example above, Phase II could even be coded D8090 if the patient was adult dentition depending on when Phase II treatment commences. I am on the Council on Orthodontic Healthcare and have studied this at great length, these opinions are my own and we all have different perspectives but I wanted to share my perspective with you.
The ADA responded to a similar question about the use of D8070 for Phase I in the following way: “We have studied your inquiry. If you are asking, with the Interceptive orthodontic treatment subcategory being deleted effective January 1, 2022, can you report CDT codes D8070 and D8080 for (Phase 1 and Phase 2) treatment? The answer is no. The procedures that would have been reported with Interceptive codes (D8050 and D8060) are to be reported with the applicable Limited Orthodontic Treatment codes (D8010, D8020, D8030 or D8040).”
Would it be possible for AAO and ADA to please get on the same page about this? It would be very helpful to get specific examples of where the line is drawn between what interventions qualify as “Limited Treatment of the Transitional Dentition” (e.g. Hawley with a finger spring to correct a single tooth crossbite) vs. “Comprehensive Treatment of the Transitional Dentition” (e.g. RPE, U/L 2×4, Facemask vs. RPE U2x4 vs RPE, lip bumper, etc). I have read the CDT 2022 Coding Companion and what qualifies as D8070 is not clearly addressed.
Well stated, Renee.
Can the aao give us more guidance please? I too have the same questions as above. Also, what about dealing with Cigna insurance and how they want us to reprocess all D8060 claims. Or the fact that others still have not adjusted their fee schedules. Or how to deal with insurance companies that will not cover D8070 and D8080 for the same patient. What a headache! Examples of how to code would be useful. We need some practical advice. Please!
Agree with above
We urgently need detailed and clear guidance from the AAO regarding both 1. which code to bill (see Renee’s comment above regarding the confusion) and 2. Cigna’s request to reprocess all D8060 claims.
I’m furious at the AAO over this bungled attempt to “streamline” the codes. I’m a cleft team orthodontist and the State of Colorado has used this to completely drop Phase I orthodontic coverage. What am I supposed to tell these parents of kids with craniofacial defects? “Sorry, our professional organization that is supposed to look out for our interests just streamlined your child out of care during a critical period. You’ll just have to wait until that canine erupts into the cleft defect and then we’ll talk to the surgeon on how to fix that. Call back when Johnny turns 12.” The AAO and the ADA need to fix this with the Medicaid programs and private insurance companies now. This can’t wait until the next revision in 2023. I really feel you failed your constituency on this.
AMEN!!!!!!!!
The DMO and DHMO plans do not allow D8080 or D8070 to be used more then once and in any case the total allowed for D8080 is less than the previous combined D8060 and D8080 was. When we talk to the companies they act like we are the first to complain about it.
The AAO needs to help with the Insurance companies in question. If there is one thing I want you to do, it is not make it impossible for us to make a living. Please use our expensive dues money to benefit us
We are receiving push back from the insurance companies when we are asking to negotiate our rates for the Limited Treatment Codes. They state they are set at a regional level or that we recently had a fee increase. Those that state we have had a recent (within the past 2 years) increase, we attempt to explain that we had no idea that the Interceptive codes were going to be deleted at the time we were negotiating our rates. However, we are still losing money on these cases.
Was the April 1st Town Hall recorded?
Yes, this Town Hall was recorded. If you registered for the event, you’ll receive an email with a link to the video in 1-2 weeks. Otherwise, you’ll be able to access it on the Insurance Claims page of the website.