COVID-19: Impact on code submissions

Consultant’s Corner by Ron Inge, DDS, Chief Dental Officer, Chief Operating Officer and Vice President of Professional Services

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Much has changed as a result of the COVID-19 pandemic. There has been much confusion regarding two vital aspects of dentistry: 1. Infection control and personal protection equipment (PPE); and 2. Teledentistry.

Infection control and PPE has been required of dentists since the 1980s. COVID-19 has taken infection control and PPE to a new level. Due to the rapid onset of the pandemic, the profession and manufacturers were not prepared. This caused a dramatic spike in the cost of maintaining appropriate levels of infection control and PPE. Infection control and PPE have long been recognized as the responsibility of the owner dentist. To adjust for the dramatic increase in cost, the ADA recommended submitting CDT code D1999 – miscellaneous preventive service by report – for reimbursement for the cost of PPE.  Delta Dental does not recognize code D1999 as an appropriate code to be submitted to cover the cost of infection control and PPE. Dentists participating with Delta Dental have agreed that infection control and PPE are not billable to the patient or to Delta Dental. Delta Dental is well aware of the burden placed on our participating dentists during these unprecedented times. Under Delta Dental’s Reopening Relief Program, dentists received a check to assist with the cost of reopening their offices, such as cost for PPE requirements to treat Delta Dental patients safely.

Teledentistry has been pushed to the forefront during this pandemic. Teledentistry offers dentists and patients a viable means of communication during these challenging times. Multiple mediums are available for dentists to contact their patients. There are two codes that specify the type of communication that occurs between a dentist and patient. Code D9995 – teledentistry – synchronous; real-time encounter – defines communication that is conducted between the dentist and the patient in real time. Code D9996 – teledentistry – asynchronous; information stored and forwarded to dentist for subsequent review – defines communication in which the dentist reviews the patient’s information at a time other than when it is gathered. These codes only describe the means of communication. These codes are not billable to the patient or to Delta Dental. Delta Dental will reimburse for the services that are provided to the patient. The most common service provided during this pandemic is D0140 – limited oral evaluation – problem focused. It is appropriate to use code D0140 to triage a patient’s condition. This allows the dentist to determine whether or not the patient should be seen in the office. Code D0140 can be performed in person or virtually and submitted for reimbursement.

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