Healthcare Fraud Shield’s Latest Article: “What’s new in the CDT: Teledentistry?”

21 Mar

 

The American Dental Association develops and publishes the Current Dental Terminology (CDT) code set. According to the American Dental Association (ADA), “The purpose of the CDT Code is to achieve uniformity, consistency and specificity in accurately documenting dental treatment”.[i] As with the Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT), CDT issues information with code changes including additions, deletions, and revisions.

In 2018, the ADA released the latest file with 18 new codes, 16 revised codes, and 3 deleted codes.[ii] Additionally, there were 4 errors noted in the CDT Errata.[iii] It is important to understand how changes to any code set could impact coding, reimbursement, and analytics.

Teledentistry
The ADA introduced the following two new codes around teledentistry. The ADA describes teledentistry as not being a specific service, but a broad variety of technologies and tactics to deliver virtual services.[iv]
D9995 Teledentistry – synchronous; real-time encounter
D9996 Teledentistry – asynchronous; information stored and forwarded to dentist for subsequent review
Both of these new codes are to be reported along with another procedure that was provided to the patient on the same date of service.

Synchronous vs. Asynchronous
The ADA describes the difference between synchronous and asynchronous as[v]:

Synchronous teledentistry (D9995) is delivery of patient care and education where there is live, two-way interaction between a person or persons (e.g., patient; dental, medical or health caregiver) at one physical location, and an overseeing supervising or consulting dentist or dental provider at another location. The communication is real-time and continuous between all participants who are working together as a group. Use of audiovisual telecommunications technology means that all involved persons are able to see what is happening and talk about it in a natural manner.

Asynchronous teledentistry (D9996) is different as there is no real-time, live, continuous interaction with anyone who is not at the same physical location as the patient. Also known as store-and-forward, asynchronous teledentistry involves transmission of recorded health information (e.g., radiographs, photographs, video, digital impressions and photomicrographs of patients) through a secure electronic communications system to another practitioner for use at a later time.

The main difference between the two as noted above is the distinction between a service performed in real-time rather than information stored to be distributed at another time.

What to look for?
Since these are new codes it’s important to keep an eye on who is using the codes and why. As always, check to see if the codes are considered a covered service. If they are not included as a reimbursable service, look for any providers who submitted these codes and then resubmitted claims with different codes after receiving a denial.

[i] CDT
[ii] CDT Changes
[iii] CDT Errata
[iv, v] Teledentistry
For more information, or if you have any questions or comments, please contact us at SIU@hcfraudshield.com.

If you would like to learn more about Healthcare Fraud Shield’s analytics solution, contact us at info@hcfraudshield.com.

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