D9970 Dental Code
D9970 Dental Code Definition
The D9970 dental code is a specific procedural code used in dental billing and documentation. It falls under the category of “Adjunctive General Services” in the Current Dental Terminology (CDT) code set, which is maintained by the American Dental Association (ADA). The D9970 code is used to describe a particular type of dental service, often related to the application of materials or treatments that are not covered under other codes.
This code is essential for dental professionals as it ensures accurate billing and reimbursement for services rendered. It also helps in maintaining standardized records, which are crucial for both clinical and administrative purposes. Understanding the D9970 code is vital for dentists, dental hygienists, and billing specialists to ensure compliance with insurance requirements and to avoid claim denials.
D9970 Dental Code Description
The D9970 dental code is specifically used for the “External Bleaching for Peroxidase-Containing Agents, per Arch.” This means it applies to treatments where a dentist uses a bleaching agent containing peroxidase to whiten teeth externally. This procedure is typically performed in-office and is distinct from at-home bleaching kits or other whitening treatments.
Key Features of D9970:
- Per-Arch Basis: The code is applied per arch, meaning it covers either the upper or lower set of teeth. If both arches are treated, the code is billed twice.
- In-Office Procedure: The treatment is performed under the supervision of a dental professional, ensuring safety and efficacy.
- Peroxidase-Containing Agents: The bleaching agents used are specifically those that contain peroxidase, an enzyme that accelerates the whitening process.
When is D9970 Used?
- For patients seeking professional teeth whitening services.
- When the treatment involves the use of specialized bleaching agents.
- For in-office procedures that require professional oversight.
D9970 Dental Code Reimbursement
Reimbursement for the D9970 dental code varies depending on the insurance provider, the patient’s plan, and the geographic location. Since teeth whitening is often considered a cosmetic procedure, many insurance plans may not cover it. However, some plans may offer partial coverage if the treatment is deemed medically necessary (e.g., for discoloration caused by medication or trauma).
Factors Affecting Reimbursement:
- Insurance Plan Type: PPO plans are more likely to cover part of the cost compared to HMO plans.
- Medical Necessity: If the procedure is required for health reasons, reimbursement is more likely.
- Pre-Authorization: Some insurers require pre-authorization before approving the claim.
Average Cost and Reimbursement Rates:
| Service | Average Cost | Reimbursement Rate |
|---|---|---|
| D9970 (Per Arch) | 300−300−600 | 20% – 50% |
| D9970 (Both Arches) | 600−600−1,200 | 20% – 50% |
Note: Costs and reimbursement rates are approximate and may vary.
D9970 Dental Code Meaning
The D9970 dental code holds significant meaning in the context of dental care and insurance billing. It represents a standardized way to document and bill for external bleaching procedures using peroxidase-containing agents. This code ensures that dental professionals are compensated fairly for their services while providing transparency for patients and insurers.
Importance of D9970:
- Standardization: It provides a uniform way to document bleaching procedures.
- Transparency: Patients can clearly understand what they are being billed for.
- Efficiency: Simplifies the billing process for dental offices and insurance companies.
Conclusion
The D9970 dental code is a critical component of dental billing, specifically for external bleaching procedures using peroxidase-containing agents. Understanding its definition, description, reimbursement process, and meaning is essential for dental professionals and patients alike. By adhering to standardized coding practices, dental offices can ensure accurate billing and improve patient satisfaction.
FAQs
1. What does the D9970 dental code cover?
The D9970 code covers external bleaching procedures using peroxidase-containing agents, performed on a per-arch basis.
2. Is teeth whitening covered by insurance?
Teeth whitening is often considered a cosmetic procedure and may not be covered by insurance unless deemed medically necessary.
3. How much does a D9970 procedure cost?
The average cost ranges from 300to300to600 per arch, depending on the dental practice and location.
4. Can I use the D9970 code for at-home whitening kits?
No, the D9970 code is specifically for in-office procedures performed by a dental professional.
5. What is the difference between D9970 and other whitening codes?
D9970 is unique in that it specifies the use of peroxidase-containing agents and applies to in-office treatments only.
Additional Resources
- American Dental Association (ADA): www.ada.org
- Current Dental Terminology (CDT) Code Set: ADA CDT Codes
- National Association of Dental Plans (NADP): www.nadp.org
- Dental Billing and Coding Guides: Available through professional dental associations and online platforms.
