Sidekick - Spring 2011 - (Page 56)

Eight New Codes Introduced In CDT 2011-2012 The American Dental Association recently unveiled CDT 2011-2012 at the ADA Annual Session in Orlando, Florida. Dentistry’s newest code set will be required by HIPAA when reporting dental services performed between January 1, 2011 and December 31, 2012. 1.D1352 Preventive resin restoration in a moderate to high caries risk patient – permanent tooth Conservative restoration of an active cavitated lesion in a pit or fissure that does not extend into dentin; includes placement of a sealant in any radiating non-carious fissures or pits. After January 1, 2011, dental teams can report D1352 if the following criteria are met: 1. The patient has had a risk assessment performed and is classified as moderate to high caries risk; 2. Decay that does not extend into the dentin is removed from a permanent tooth; 3. A composite restoration is placed; and 4. A sealant is placed over any remaining non-carious fissures or pits on the occlusal surface. Also note: • D1352 involves a conservative cavity prep by the dentist. • The placement of a sealant is included in D1352 and should not be billed separately. • It is not appropriate to report D1352 if there is no active decay in the enamel, if decay extends into the dentin, or if performed on a primary tooth. By Dr. Charles Blair D2391: a sealant in any radiating non-carious fissures or pits. A one-surface posterior composite restoration in which the caries and preparation extend into the dentin or a deeply eroded area into the dentin. 2. D3354 Pulpal regeneration – (completion of regenerative treatment in an immature permanent tooth with a necrotic pulp); does not include final restoration Includes removal of intra-canal medication and procedures necessary to regenerate continued root development and necessary radiographs. This procedure includes placement of a seal at the coronal portion of the root canal system. Conventional root canal is not performed. Pulpal regeneration is performed on a non-vital permanent tooth with incomplete root development, necrotic pulp, and open apex. The tooth is opened, the pulp space disinfected, intra-canal medication placed, and temporary cement is used to seal the canal. Once regeneration and healing are complete, placement of a coronal seal completes the procedure, and the tooth is ready for final restoration. The goal of pulpal regeneration is to recreate vital pulp and generate continued root maturation and development in order to avoid root canal therapy. Since the procedure often requires multiple visits and applications of intra-canal medication for successful outcomes, the visits are coded as follows: D3351 Initial visit to open the tooth, prepare the canal spaces, and place the initial medication —Includes working radiographs D3352 Additional pulp disinfection procedures and interim medication replacement —May require multiple visits; each visit is reported as D3352 D3354 Final visit may involve re-entering the tooth, irrigating the root canal system, re-initiating bleeding, and sealing with MTA —The final coronal restoration will depend on the patient’s individual need and is billed separately Reporting and Reimbursement Considerations Dental carriers are expected to carefully monitor the reporting of D1352 because of concern that this code has the potential for abuse similar to claims submitted for multiple one-surface posterior composites—especially for children with no history of caries. Some dental plans are expected to pay an alternate benefit of a sealant, while others are expected to establish a separate allowable fee that will be more than a sealant but less than a one-surface posterior composite restoration. Carriers will likely require a narrative citing the risk factors that qualify the patient as moderate to high caries risk if it is not obvious from the patient’s claims history. Keep this in mind whenever a patient’s dental plan changes. Note the Difference D1351: A sealant placed on the enamel surface to prevent decay. The enamel surface is noncarious. D1352: A conservative restoration of an active cavitated lesion in a pit or fissure, which does not extend into the dentin also includes placing Reporting and Reimbursement Considerations Carriers are expected to pay the final visit for pulpal regeneration (D3354) at a fee similar to that paid for the final SIDEKICK 56 Spring 2011 Sidekick

Table of Contents for the Digital Edition of Sidekick - Spring 2011

Sidekick - Spring 2011
Table of Contents
Dr. Penny Resnick-Graulich Main Street Pediatric Dentistry
DEXIS—A Driving Force in My Practice
7 Ways to Use Content for Better Online Marketing
Clay Center Family Dental Care
Planning Your Exit Strategy: Five Key Questions to Ask Before Making a Move
Realizing the Difference in Chairside CAD/CAM Systems
Quarterly Featured Designs
Roger M. Harris III Family Dentistry Greer, South Carolina
A Slice of Everyday Life
Eight New Codes Introduced in CDT 2011–2012
Why Do Patients Choose You?
Facebook for the Dental Practice
CBCT—Key to an “Uneventful” Implant Experience
Midwestern University Dental Institute Glendale, Arizona

Sidekick - Spring 2011