CDT coding questions, answered in plain English

Use D9310 when another dentist, physician or qualified provider asks for your professional opinion on a specific problem. The record should show the referral question, findings and a report back to the referring provider.

If the patient presents for diagnosis or treatment in your office and becomes your patient, an evaluation code such as D0140, D0150 or D0160 may better match the service. Code what was requested, documented and performed.

Common choices are D0150 for a comprehensive oral evaluation or D0180 when a comprehensive periodontal evaluation with periodontal charting is performed. Either code may apply to a new or established patient when the documented components support it.

D0140 reports a limited, problem-focused evaluation for a specific complaint such as pain, swelling, a broken tooth or trauma. Document the chief complaint, focused findings, diagnosis and next step.

Generally, no. D0180 includes the clinical scope of a periodic evaluation plus a comprehensive periodontal assessment. When the doctor performs the full periodontal evaluation, report D0180 rather than adding D0120.

No. CDT codes are not restricted by specialty. Any dentist may report a CDT code when the service is within the scope of their license and the documentation supports the procedure.

D0145 reports an oral evaluation for a patient under age three and includes counseling of the primary caregiver. Chart the age, findings, risk factors, anticipatory guidance and caregiver counseling.

No. D0210 refers to a complete series of intraoral images. A panoramic image is extraoral and is reported with D0330. Bitewings are reported separately with the applicable D0270–D0277 code.

D0273 reports three bitewing images. Keep the images, date, reason and interpretation in the chart, especially when frequency limits or medical-necessity review may apply.

CBCT codes distinguish image capture with interpretation from image capture only, and they vary by field of view. D0364–D0368 are commonly used when capture and interpretation are performed; D0380–D0386 are used for capture only. Verify the current CDT manual and payer policy before billing.

D0460 reports pulp vitality testing. The service may include testing more than one tooth for comparison. Many payers bundle it with an evaluation or endodontic procedure on the same date, so the clinical note should explain why the test was needed.

In CDT, the choice is based on dentition: D1120 for child prophylaxis and D1110 for adult prophylaxis. Dental plans may still apply their own age-based benefit rules, so verify plan limitations before quoting benefits.

It may be appropriate only when different areas are treated and the documentation clearly separates the services. Many plans limit or deny both on one date. Chart the quadrants or teeth treated, periodontal findings and the reason each service was necessary.

D1206 reports fluoride varnish. D1208 reports topical fluoride other than varnish. Plans commonly apply age, frequency and caries-risk limits.

CDT 2026 deleted D1352 for preventive resin restoration. Published payer summaries state that D2391 was revised for a one-surface posterior resin restoration without depending on whether the lesion extends into dentin. Verify the final descriptor in the current CDT manual before claim submission.

D1354 reports application of a caries-arresting medicament per tooth. D1355 reports a caries-preventive medicament per tooth. Because benefit rules vary, check age limits, tooth limits, frequency and whether a narrative or caries-risk documentation is required.

No. Cleaning and inspection of a removable appliance has separate CDT codes in the D9932–D9935 range. A prophylaxis is for cleaning the natural dentition or a fixed prosthesis when applicable.

Report what was performed. If two distinct restorations were placed on separate surfaces, they may be reported separately. Some plans combine them under alternate-benefit or bundling rules, so document the separate lesions, surfaces and materials.

D2140 reports a one-surface amalgam restoration. D2150 reports two surfaces, D2160 reports three surfaces and D2161 reports four or more surfaces. Confirm against the current CDT manual and payer policy.

D2335 is used for an anterior resin restoration involving four or more surfaces or the incisal angle. The chart should list the tooth, surfaces, material and whether the incisal angle was involved.

D2740 is commonly used for a ceramic crown, including zirconia. Document the tooth, material, indication and whether any build-up or post procedure was separately performed and supported.

D2950 is supported when significant tooth structure is missing and the build-up is needed to retain the final restoration. The note should explain the missing structure and retention need. It should not be used simply as routine filler under every crown.

D2940 reports a protective restoration placed to relieve pain, protect the tooth or promote healing. It is not the correct code for a temporary crown or provisional restoration placed between crown appointments.

Most CDT codes describe completed services. If no specific code fits, use the applicable unspecified “by report” code, such as D2999 in restorative, with a clear narrative explaining what was completed and why the procedure stopped.

Root canal therapy is coded by tooth type: D3310 for anterior teeth, D3320 for premolars and D3330 for molars. Retreatment uses D3346–D3348 by tooth type. Verify tooth number, prior treatment status and final obturation in the record.

A therapeutic pulpotomy, D3220, is not reported when it is the initial stage of root canal therapy on the same tooth. If the pulpotomy is a separate definitive service, the documentation should make that clear.

D3332 reports incomplete endodontic therapy when treatment cannot be completed because the tooth is inoperable, unrestorable or fractured. Include the reason treatment stopped and what portion of care was completed.

Scaling and root planing should be supported by periodontal charting, clinical attachment loss, pocket depths, bleeding or inflammation as applicable, calculus, and radiographic evidence of bone loss in the treated area. D4341 applies to four or more teeth in a quadrant; D4342 applies to one to three teeth in a quadrant.

D4346 reports full-mouth scaling in the presence of generalized moderate or severe gingival inflammation after an oral evaluation, when the patient does not have the attachment loss and bone loss that support SRP. It is not a substitute for SRP or a routine prophylaxis.

D4910 is appropriate after active periodontal therapy, such as SRP or periodontal surgery. It is not a substitute for a prophylaxis for a patient who has never received periodontal treatment.

No. D4355 is used when heavy plaque and calculus prevent the dentist from completing a comprehensive evaluation. It is a preliminary service, not a prophylaxis, and the follow-up evaluation should be documented.

D5110 reports a maxillary complete denture and D5120 reports a mandibular complete denture. Immediate complete dentures are reported with D5130 for maxillary and D5140 for mandibular. Confirm whether relines, adjustments or repairs are included under the payer’s post-delivery rules.

Choose based on how the crown is supported. D6058 is used for an abutment-supported crown, where an abutment is placed and the crown is attached to that abutment. D6065 is used for an implant-supported crown attached directly to the implant. Verify the restorative design and payer requirements.

No. Splinted single crowns are still reported as individual crowns. A bridge uses retainer and pontic codes. The treatment plan and lab prescription should match the codes submitted.

Include the date and reason for tooth loss when known, current radiographs, periodontal status, restorative plan and a narrative. Many plans apply missing-tooth clauses, implant exclusions, waiting periods or alternate benefits.

D7140 reports removal of an erupted tooth or exposed root using elevation and/or forceps. D7210 requires surgical removal with bone removal and/or tooth sectioning. The operative note should clearly describe the surgical steps when D7210 is billed.

Impaction codes are based on the tissue covering the tooth: D7220 for soft tissue, D7230 for partially bony, D7240 for completely bony and D7241 for completely bony with unusual surgical complications. Keep radiographs and the operative note.

D7953 reports a bone replacement graft for ridge preservation, per site. Grafting placed at the time of implant placement uses D6104. Document the site, material, clinical indication and whether the graft was performed with extraction or implant placement.

Common dental biopsy-related codes include D7285 for incisional biopsy of hard tissue, D7286 for incisional biopsy of soft tissue, D7287 for exfoliative cytology and D7288 for brush biopsy. The pathology laboratory typically bills its own service, often to medical insurance.

Sometimes, when the procedure is medically necessary and supported by the medical plan’s coverage rules. Examples may include trauma, pathology, certain medically necessary extractions or reconstruction. Medical claims use CPT and ICD-10-CM codes, and documentation must support the diagnosis and procedure.

Limited treatment, D8010–D8040, addresses a specific problem. Comprehensive treatment, D8070–D8090, treats the whole dentition. Choose based on treatment scope, not the appliance type alone.

D8670 reports a periodic orthodontic treatment visit. Many plans pay orthodontic benefits on a case-fee or scheduled basis rather than per visit, so review the contract and plan payment schedule.

D9230 reports inhalation of nitrous oxide. Published CDT 2026 summaries state the descriptor was revised to clarify use when nitrous oxide is the single agent. Verify the exact wording in the current CDT manual.

CDT 2026 deleted D9248 for non-intravenous conscious sedation and added new anesthesia codes. Select the current code by route, depth or level of sedation and documented service. Do not crosswalk automatically without reviewing the current CDT manual and payer policy.

D9944 reports a hard full-arch occlusal guard, D9945 reports a soft full-arch guard and D9946 reports a hard partial-arch guard. Appliances used for TMD treatment are generally reported as an occlusal orthotic device, D7880, when supported by the record.

D9995 reports synchronous, real-time teledentistry. D9996 reports asynchronous, store-and-forward teledentistry. These codes are reported in addition to the clinical procedure delivered, when payer policy allows.

Dental claims may use D9947 for custom appliance fabrication and placement, D9948 for adjustment and D9949 for repair. Medical plans often require HCPCS E0486 for a custom oral appliance for obstructive sleep apnea. Medicare coverage for E0486 requires a physician diagnosis, LCD L33611 criteria and DMEPOS enrollment; ICD-10-CM G47.33 identifies obstructive sleep apnea. Always verify payer rules before treatment and billing.

Use the CDT version in effect on the date of service. CDT updates take effect each January 1. Train the team to update practice-management software, claim templates, narratives and fee schedules before the first claims of the year go out.

Most commercial dental plans do not require diagnosis codes for routine dental claims, but the ADA claim form supports ICD-10-CM diagnosis reporting. Medicare dental services that are inextricably linked to covered medical services require an appropriate diagnosis code and the correct KX or GY modifier, depending on whether coverage criteria are met. Medical and dental-to-medical claims should use accurate ICD-10-CM codes supported by the chart.

An alternate benefit is a plan provision that pays based on a less costly covered procedure than the one performed, such as an amalgam benefit for a posterior composite. Patient responsibility depends on the plan, state law and network contract terms.

Submit to the primary plan first. Then send the secondary claim with the primary explanation of benefits and payment information. Coordination of benefits rules, including non-duplication provisions, determine whether the secondary plan pays additional benefits.