Dental Case Management Coordination - CDT Code Guide
Overview
CDT code D9992 pertains to the coordination of dental care across various providers and specialties. This code is used when a dental professional assists a patient in making informed decisions regarding their oral health care, especially when multiple providers or specialties are involved. It involves the additional time and resources required to offer expertise that the patient may not possess. This service ensures that the patient receives comprehensive care tailored to their unique needs, facilitating communication between different health care settings and payment systems. Typical scenarios include managing complex treatment plans that involve orthodontists, periodontists, and general dentists, or coordinating care for patients with special needs who require services from multiple specialists.
When to Use This Code
- Coordinating care for a patient requiring services from both a periodontist and an orthodontist.
- Assisting a patient with special needs in accessing dental services across multiple specialties.
- Managing a comprehensive treatment plan that involves oral surgery and restorative dentistry.
- Facilitating communication between a dental office and a patient's primary care physician for integrated care.
- Helping a patient navigate insurance coverage for a multi-specialty dental treatment plan.
Documentation Requirements
- Detailed notes on the coordination activities performed.
- Documentation of the time spent on coordination efforts.
- Records of communication with other health care providers.
- Patient consent for sharing information across providers.
- Evidence of the necessity for coordination due to the complexity of the case.
Billing Considerations
When billing for D9992, it's important to note that this code is typically used for non-clinical procedures and may not be covered by all insurance plans. It is crucial to verify with the patient's insurance provider regarding coverage and any applicable frequency limitations. Common modifiers may include those indicating the involvement of multiple providers. Ensure that all coordination activities are well-documented to support the claim.
Related CDT Codes
Frequently Asked Questions
Coverage for D9992 varies by insurance provider. It's essential to verify with the patient's insurance plan to determine if coordination of care services are covered.
Need help with dental coding?
Our AI-powered assistant can answer your CDT code questions instantly.