NESO News

Council on Health Care (COHC) Update March 2021 eNews

CODE CHANGES APPROVED BY THE ADA CODE MAINTENANCE COMMITTEE

Dr. Marlin Salmon

As your NESO representative to the AAO/COHC, I am pleased to inform you that the three-code action requests the AAO submitted were approved by this year’s ADA Code Maintenance Committee.  COHC’s 2020 member poll revealed that “Determining when a case is Limited vs. Interceptive” and “Determining when a case is Limited vs. Comprehensive” were two coding areas of concern for members.

As a result, the AAO requested the following code changes:

  • Delete Interceptive orthodontic Treatment subcategory nomenclature, descriptor, and codes D8050 and D8066.
  • Revise Limited Orthodontic Treatment Descriptor.
  • Delete Code D8690 Orthodontic Treatment (alternative billing to a contract fee).

The new language for Limited Orthodontic Treatment will be as follows:

  • Orthodontic treatment utilizing any therapeutic modality with a limited objective or scale of treatment. Treatment may occur in any stage of dental development or dentition.  The objective may be limited by:

– Not involving the entire dentition.

– Not attempting to address the full scope of the existing or developing orthodontic problems.

-Mitigating an aspect of a greater malocclusion (ie crossbite, overjet, overbite, arch length, anterior alignment, one phase of multi-phase treatment, treatment prior to the permanent dentition, etc.

-A decision to defer or forgo comprehensive treatment.

The following codes will apply to services rendered on or after January 1, 2022, and should help to eliminate ambiguity and redundancy:

  • D8010 limited orthodontic treatment of the primary dentition.
  • D8020 limited orthodontic treatment of transitional dentition.
  • D8030 limited orthodontic treatment of adolescent dentition.
  • D8040 limited orthodontic treatment of permanent dentition.

Deletion of code D8690 should help to reduce confusion for members.  Representatives from both the ADA and the National Association of Dental Plans (N.A.D.P.) agreed with the AAO’s position that D8690 does not truly represent a procedure, is redundant with other existing codes, and is no longer needed.

COHC works hard to improve the lives of our members and believes these code changes will be helpful and beneficial to all members submitting for these procedures.

Marlin Salmon, NESO-COHC Representative