What is Dental Coding? Key Codes, Rules, and Processes

Dental coding is the use of standardized codes in claim submission forms to represent dental procedures, enabling insurance companies to identify procedures and process claims accordingly.

In this article, we’ll explore all the essentials of dental coding, including how it works, common pitfalls, and best practices. It’s a practical and easy-to-understand guide designed as a valuable resource for your dental care providers, billing staff, and practice managers.

What Are CDT Codes and How Do They Work?

Dental coding heavily relies on the CDT codes, and it’s important to know what these are and how they are applied, so you accurately enter codes for each procedure while filing claims.

CDT Coding Fundamentals

The principal code set used in dentistry is the Current Dental Terminology (CDT), published annually by the ADA. Here are the coding fundamentals you must know while entering codes for dental procedures.

• Code Structure: CDT codes use a standard 5-character format: letter “D” + four digits (e.g., D1110, D2740, D4341)
• Precise Definitions: Each CDT code has a specific definition that describes procedure intent, included components, and qualification details (e.g., surfaces, units).
• Correct Coding: Always code exactly the procedure that’s performed. There must be no downcoding or adjusting for payer coverage.
• Documentation Support: Documentation must match the code: clinical notes, radiographs, photos, perio charting, and narratives when needed.
• Bundled Services: Some codes include components like anesthesia, suturing, or irrigation. These cannot be billed separately.
• Authorization Limits: Many codes require prior authorization or have frequency limits (e.g., prophy: 1-2 times per year, scaling and root planning: 24-36 months).
• Strong Narratives: Clear and concise narratives reduce claim denials, especially for scaling and root planning, night guards, and procedures requiring prior authorization.
• Category Ranges: CDT covers all the categories of dental care, as explained in the table below.

How Accurate Coding Benefits Your Practice

Using accurate CDT codes for each dental procedure is an essential component of your entire dental billing and coding process. Doing so helps:

• Ensure insurance claims are properly processed. Insurance companies rely on CDT codes to review your claims.
• Prevent claim denials or delays caused by outdated or incorrect codes. For example, using a retired code from a previous year can trigger rejection.
• Maintain clear and standardized patient records. CDT codes and descriptors provide a standardized explanation for treatment records, audits, and reporting.

CDT Updates

The CDT codes are updated annually by the ADA’s Code Maintenance Committee (CMC). These updates include:

• New codes for emerging procedures or technologies.
• Revised descriptors for clarity or accuracy.
• Deleted codes that are outdated or no longer in use.

Billers must follow updated CDT code lists for precise coding procedures.

Now, for instance, ADA has announced its upcoming CDT 2026 update for the next year. It has 60 updates, including 31 new codes, 14 revisions, 6 deletions, and 9 editorial changes, effective from January 1, 2026. 

Based on that, we’ll describe the major CDT changes your billers must follow in 2026.

First, let’s discuss the codes that are deleted and no longer in practice.

Now, in the next table, we’ll discuss new additions to the CDT code sets.

Now let’s review the revised descriptors in the 2026 updates.

How Does the Dental Coding Process Work: Step-by-Step Guide

Coding a dental procedure isn’t just about choosing a code and entering it into the claim form. It’s a complete process that dental billers must follow to ensure accuracy, compliance, and proper documentation for speedy and complete claim reimbursements.

These are the following steps:

• Reviewing the payer-specific coding requirements
• Selecting the appropriate CDT code for each procedure
• Code for procedures without exact matches in CDT code lists
• Handle multiple procedures / comprehensive visits
• Add modifiers to requirements
• Cross-code with medical coding for medically necessary dental procedures
• Reviewing documentation requirements for CDT coding
• Submitting insurance claims
• Tracking coding errors and rectifying mistakes in case of claim denials

Review the Payer-Specific Coding Requirements

CDT codes standardize dental procedure names, but they can’t guarantee coverage or payment by the insurers.

The reason is that payers decide which CDT codes they cover, how often, and under what circumstances. 

For example, some payers may cover D1110 (adult prophylaxis) only twice per year, while D1999 (unspecified preventive) may require prior authorization. 

Similarly, a payer may cover D1355 (caries-arresting medicament) only for patients under 18, and if a coder uses this code for a procedure on adults without checking the payer requirements, it results in a straight claim denial.

Policies vary per insurance company, so you must review the codes your payer accepts and entertains. It helps you enter the correct codes beforehand, reducing effort and saving time for your staff.

Select the Appropriate CDT Code

The dentist determines what services are provided to a patient, which includes all the key details, such as:

• Type of procedure
• Tooth number
• Surfaces
• Materials

Following that, a dentist is responsible for choosing the appropriate code from the CDT code list for every dental procedure. This code entry consists of a code, nomenclature, and descriptor (if applicable).

For example, if a dentist performs a routine adult cleaning, the exact CDT code entry they must choose for billing is as follows:

• Code: D1110
• Nomenclature/Category: Preventive
• Descriptor: Prophylaxis – Adult

The billing team must verify the code, nomenclature, and descriptor, if these are accurate and match the updated CDT code list, before submitting claims.

Doing so ensures that the payer knows exactly what procedure is performed and can process the claim correctly.

Note: Avoid entering a code that may offer you higher reimbursements, but isn’t accurate, as this can lead to claim denials, and even audits and legal complications for your practice. Therefore, you must use the right code.

Code for Procedures without Exact Matches

If there’s no exact match, use an “unspecified … by report” code (e.g., D1999 unspecified preventive procedure), but accompany it with reasoning and detailed documentation describing the procedure for proper justification.

For example, a custom fluoride varnish application combined with oral hygiene instruction for a patient with special needs doesn’t fit any of the standard CDT preventive codes. 

In that case, you can code it as D1999 and describe all the details, while also mentioning that you’ve selected this code, as there isn’t any available appropriate code for it in the list.

The table below describes some of the most common “unspecified / by report CDT codes”.

Handle Multiple Procedures / Comprehensive Visits

Many patient visits involve more than one service, such as cleaning, filling, and X‑rays. Each service should be coded individually, with:

• Appropriate modifiers (if required)
• Tooth numbers/surfaces
• Supporting documentation

While doing so, avoid unbundling or billing component services separately when a single CDT code defines them as part of a comprehensive service.

For example, if a dentist places a resin-based composite filling on an anterior tooth, the comprehensive code for a single-surface restoration is D2330 (resin-based composite, one surface, anterior). 

Here, it’s unbundled, if you bill the following three separately:

• D2330 (Resin-based composite, one surface)
• D2391 (Additional surface on the same tooth)
• D2740 (Crown preparation)

And this is incorrect if the dentist only does a one-surface composite filling, because everything needed for that procedure is already included in D2330. Therefore, it can’t be billed separately. You must bill it together in one code.

Add Modifiers Upon Requirement

Modifiers are short two-digit codes added to a CDT code to indicate special circumstances, multiple surfaces, or exceptions, helping clarify the procedure performed on a patient. Certain dental procedures can require these modifiers to present a clearer picture to the payer.

Currently, ADA and the Centers for Medicare & Medicaid Services (CMS) accept only two modifiers in CDT coding. These are:

Now, in the case of a CDT code with modifier “GY” that refers to a private insurer, you must first verify with the insurer’s policies and see if it entertains this coding and claim.

Perform Medical-Dental Cross Coding

There are some circumstances where you need to include diagnosis codes, often with ICD‑10‑CM, an international coding system for diagnosis and medical conditions. This is done for procedures that involve:

• Diagnosis (e.g., treatment of disease)
• Cross-coding into medical‑insurance coverage (e.g., oral surgery, sedation).

Here is a table featuring examples of CDT codes that describe the dental procedure, while ICD‑10‑CM codes describe the diagnosis, ensuring coverage when dental care intersects with medical necessity.

There are instances when a dental procedure has medical necessity, or it overlaps with medical coverage. In that scenario, you need to link CDT codes to CPT (Current Procedural Terminology) codes, which are used for medical procedures and services. 

Let’s explore some common examples of CDT and CPT linking.

Similarly, when dental procedures involve medical devices, prosthetics, or medically necessary services covered by medical insurance, CDT codes can be linked to HCPCS Level II codes, which are used to identify medical procedures, supplies, and durable medical equipment.

Let’s review the situations where this linking can be applicable in this table.

However, you must review your payer policies once to confirm if your insurer facilitates cross-coding or the use of diagnosis codes for certain procedures.

Review Documentation Requirements for CDT Coding

Accurate CDT coding depends on complete and detailed documentation. The clinical record clearly shows the findings, procedures, and reasoning, making your claim approvals smoother and reducing coding errors.

So, let’s navigate the documentation requirements generally required for CDT coding in this table.

These requirements vary per insurer, so you must check your insurer’s documentation requirements for each code.

Submit Insurance Claims

While submitting your claims, use the version of CDT effective on the date of service. For example, if you’re billing codes after 2026, you can’t use the code D1352 for preventive resin restoration, as it’ll be merged into D2391 (resin-based composite restoration – one surface, posterior).

For electronic claims, the correct CDT code is mandatory under the Health Insurance Portability and Accountability Act (HIPAA) standard transactions. So, you must follow HIPAA guidelines to ensure compliance.

Track Claim Progress

If a claim is denied, review the submitted codes and documentation and proceed accordingly. Let’s review two scenarios of claim denials, so your billers get an idea of how to respond to claim denials, with examples.

Considering this information, maintain complete patient records for compliance and potential audits.

What Are the Most Common CDT Codes Every Dentist Should Know?

While a full CDT manual is the definitive reference to all the CDT codes, here’s a quick cheat sheet of commonly used codes across general dentistry for frequently treated procedures. A basic knowledge of these codes is useful for a smooth everyday practice and billing.

Let’s review the table below:

Many smaller practices or new dental offices find that these codes cover a large portion of routine visits. Familiarity with them makes billing accurate and faster.

However, while these are the most common CDT codes, this list can be elaborated per practice and state requirements. 

For example, some procedures may be performed with high frequency in New York state, but their frequency may be lower in Texas. So, it all depends on your practice requirements, and it can be modified.

What Are the Most Common Dental Coding Mistakes?

Using codes incorrectly can significantly impact your dental billing process and the overall revenue of the dental practice. It causes claim denials, underpayments, reimbursement delays, or even audit flags that can put your practice’s finances and reputation at risk.

To prevent that, let’s review some common pitfalls in dental coding, with corrective actions.

Using the Wrong CDT Code

Selecting a code from the wrong category or using a similar code is a frequent mistake. It usually happens due to a lack of familiarity with the CDT manual or confusion with similar codes. 

Suppose a dentist has actually placed D2790 (crown for full cast high noble metal), but you’ve coded D2740 (crown for porcelain/ceramic). Both are crown codes, but for different materials. This makes the coding wrong and leads to claim rejection.

Solution: Regularly review CDT descriptors, consult the official ADA manual, and verify that each code matches the procedure exactly.

Using Outdated or Retired Codes

Submitting claims with codes that have been retired or replaced in the latest CDT version is a common error. It often occurs when practices fail to update code manuals annually. The impact is claim rejection or processing delays due to version mismatches. 

For example, submitting D9248 (non-IV sedation), when it has been replaced by new anesthesia codes in the 2026 CDT update, could trigger a denial. 

Solution: Always maintain the most current CDT manual and cross-check any code before submission.

Upcoding

Upcoding occurs when a dental procedure is billed as more complex or expensive than what was performed. This can be intentional or accidental and usually results from wrongly classifying or interpreting descriptors. Impact can be huge, leading to financial, legal, and reputational risks that include claim rejections, external audits, and potential repayment requests.

For instance, coding a D2335 (two-surface composite) as D2392 (three-surface) inaccurately increases reimbursement, but makes your practice prone to legal audits. Similarly, if you bill D4341 (full quadrant scaling) when only a few teeth are treated, the insurance may pay initially, but then issue a repayment request for the difference.

Solution: Ensure procedures are coded accurately based on documentation and never select codes solely for higher reimbursement.

Undercoding

Undercoding happens when a lower-reimbursement code is submitted. Fear of rejection or lack of documentation often causes this. The impact is lost revenue and incomplete compensation for services rendered.

For example, recording a D2150 (amalgam for two surfaces) as D2140 (one surface) reduces your actual payment, leading to a massive revenue loss for your dental practice.

Solution: Maintain detailed documentation and code precisely for the actual procedure performed.

Unbundling

Billing each component of a comprehensive procedure separately, even though one CDT code includes them, is a common error. It usually arises due to not knowing the bundling rules. Consequences include claim denials or reduced payment. 

For example, billing D6980 (suture removal) separately from D4210 (periodontal surgery) is considered unbundling, while the latter code includes suture removal.

Solution: Review code definitions carefully, understand included components, and bill only the comprehensive code.

Incomplete Documentation

Missing details such as tooth numbers, surfaces, or descriptors often result from rushed record-keeping. This leads to claim delays, denials, or audits. 

For example, coding a crown replacement without specifying the tooth number and surface can trigger rejection.

Solution: Ensure complete clinical documentation, including tooth number, surfaces, quadrant, materials, and any supporting radiographs or photos to justify your details.

Mixing Restorative vs. Interim Restoration Codes

Specialty mistakes often occur when outdated interim restoration codes are used instead of current restorative codes. The ADA annually makes updates to the CDT code list, merging older codes into updated ones. Due to that, using an obsolete code can result in denied claims.

Suppose a dentist used D2940 (sedative/resin-based temporary restoration) for a procedure that, in the 2026 CDT update, is now captured under D2990 (resin-based restorative procedure, by report). Because D2940 is now outdated/merged, submitting it could trigger a claim denial.

Solution: Verify the latest CDT version and confirm that the code aligns with the current procedure definitions.

Missing Location Details (Tooth, Surface, Arch)

Failing to specify tooth number, surface, or arch is frequent in prosthodontics, implants, or oral surgery. ADA guidelines stress accurate location reporting for the:

• Area of the oral cavity:
• Entire area
• Arch
• Quadrant
• Tooth anatomy:
• Tooth number
• Range number
• Surface

Details must not be missed and entered accurately. Missing them or entering them incorrectly leads to claim denials or audits.

Now, let’s understand this with an example. Suppose a dentist places a crown on tooth #30 and submits the claim with D2790 (crown – full cast high noble metal), but omits the tooth number and surface. Because the payer cannot verify the treated tooth number, the claim may be denied or delayed, even though the procedure itself is medically necessary.

Solution: Always include precise tooth numbers, surfaces, and arches when coding these procedures.

Using Generic or “Unspecified” Codes

Submitting an unspecified code when a more specific code exists can lead the payer to deny your claim request and even conduct audits. Billers often do so to avoid choosing incorrectly, but it may delay reimbursement.

For example, using D1999 (unspecified preventive) instead of an available code for adult prophylaxis (D1110) may lead to payers demanding an explanation.

Solution: Use specific codes for a procedure if available; reserve “unspecified” codes for truly unique procedures with detailed narratives and no exact matches in the CDT code list.

Neglecting Annual Code Updates

Failing to update CDT codes in your database annually may result in missed coverage for newer procedures effective in 2026, like D0426 (saliva testing) or D0461 (testing for cracked tooth). This can lead to missed revenue opportunities and claim denials if you don’t use appropriate codes for procedures according to the latest updates.

Solution: Review CDT updates yearly and integrate new codes into billing practices immediately after these updates are released by the ADA.

Specialty Dental Coding: Detailed Breakdown

Dentistry spans multiple specialties, due to which you need to bill each procedure according to the category. Each of these categories has unique codes, which you must follow properly to accurately code procedures.

Diagnostic Coding

Diagnostic coding category includes all the CDT codes that cover examinations and evaluations performed to identify a dental condition.

Diagnostic codes are in the D0100–D0999 series.

Some major examples of diagnostic CDT codes include:

Using clinical notes to specify findings (e.g., caries severity, periodontal status) justifies your procedure selection.

Preventive Coding

Preventive coding reports dental services that stop disease before it starts, such as cleanings, sealants, and fluoride treatments. These codes often require clear documentation of age, tooth number, and surfaces treated.

Preventive CDT codes are in the D1000-D1999 series.

Some common preventive codes are:

In some instances, you may need to use multiple codes. For example, for a 7-year-old receiving fluoride and sealant on molars, both D1120 and D1351 should be applied with accurate tooth numbers.

Restorative Coding

Restorative coding reports procedures that repair tooth structure damaged by decay, fracture, or wear.

These codes are in the D2000-D2999 series.

Common restorative CDT codes are:

Follow these considerations while coding for restorative services:

• Use correct surfaces (mesial, distal, occlusal) to avoid denials.
• Do not bill base or liner separately if included in the restoration code.

Endodontic Coding

Endodontic coding captures procedures related to pulp therapy, root canal treatment, and other procedures involving the dental pulp and root structures.

These codes are in the D3000-D3999 series.

Common endodontic codes include:

While coding for endodontic procedures, make sure to:

• Always select the code that matches the tooth type and number of roots (anterior, bicuspid, molar) to avoid over- or undercoding.
• Document all pulp therapy procedures, retreatments, and apexification visits clearly, including tooth number and any complications, to support accurate billing and reduce denials.

Periodontal Coding

Periodontal coding reports the diagnosis and treatment of gum disease, bone loss, and supporting structures of the teeth.

These codes are in the D4000-D4999 series.

Common codes include:

While coding periodontal procedures:

• Include pocket depths, periodontal charting, and radiographs to support scaling or surgical procedures.
• Specify quadrant or full-mouth treatment as required by the CDT descriptor.

Prosthodontic Coding

Prosthodontic coding is used for coding dentures, bridges, implants, and other tooth-replacement procedures. In fact, some complex procedures in prosthodontics require dedicated coding expertise and workflows, such as dentures and implants coding.

Prosthodontic codes are categorized in the D5000-D6999 series. This category is divided into three main sub-categories.

These include:

• Removable prosthodontics
• Maxillofacial prosthetics
• Implants
• Fixed prosthodontics

Let’s explore the purpose of all these subcategories with the most frequent codes in each category.

Removable Prosthodontics

This category captures dental procedures for creating and maintaining removable dental prostheses, including complete and partial dentures, and resection prostheses. Series are D5000-D5899.

Common codes are:

Maxillofacial Prosthetics

Maxillofacial prosthetics covers specialized dental prostheses that restore or replace facial and oral structures lost due to trauma, surgery, congenital defects, or disease.

These procedures are billed in the D5900-D5999 series. Common procedures include:

Implants

Implant codes capture placement, maintenance, and removal of dental implants, as well as implant-supported prostheses.

These procedures are covered in the D6000-D6199 series. Common codes are:

Fixed Prosthodontics

Fixed prosthodontics codes cover permanent restorations such as crowns, bridges, and related procedures that are cemented or bonded in place. These are billed in the D6200-D6999 series.

Common fixed prosthodontics codes include:

Oral Surgery Coding

Oral surgery coding covers all the oral surgery procedures, such as surgical extractions, incisions, bone procedures, and treatment of pathological oral conditions.

These procedures are billed in the D7000–D7999 series.

Common oral surgery codes include:

While billing oral surgery procedures:

• Document tooth numbers, surgical site, anesthesia type, and complexity of the extraction or procedure.
• Include any adjunctive procedures like suture removal only if the payer allows separate billing.

Orthodontic Coding

Orthodontic coding reports diagnostics and treatments used to align teeth and correct bite issues in children and adults.

These are billed in the D8000-D8999 series.

Orthodontic coding examples include:

In orthodontics, follow these key recommendations for precise coding:

• Document treatment type (comprehensive, limited, interceptive) and appliance used.
• Note start and end dates, tooth movement, and any adjunctive procedures.

Adjunctive General Services

Adjunctive General Services include procedures that support or complement primary dental treatments, such as palliative care, sedation, occlusal therapy, photobiomodulation, and other miscellaneous services. 

These codes, billed under the D9000-D9999 series, are often used to document supportive care or procedures not covered under standard categories.

Common codes of adjunctive general services are:

While entering codes for adjunctive general services:

• Document procedure type, duration, patient condition, and monitoring for each procedure.
• Include consent forms and clinical notes, especially for sedation, anesthesia, or emergency treatments, to support medical necessity and payer compliance.

Pediatric Dentistry Coding

Pediatric coding reports diagnostic, restorative, and preventive services designed specifically for infants and children. These procedures overlap with all the above categories in dentistry.

Common pediatric codes are:

Key recommendations for coding pediatric dentistry procedures are:

• Recording age-appropriate preventive and restorative procedures, including sealants and pulp therapy.
• Specifying tooth type and surfaces for pediatric restorations and extractions.

General Dentistry Coding

General dentistry coding reports routine examinations, radiographs, diagnostics, and emergency treatments used across all patient types. These usually overlap with other categories of dental coding.

Some examples include:

Rules and Regulations for Dental Coding

Let’s have a quick revision of the essential rules and regulations for dental coding, which we’ve discussed above, so your staff can find them all in one place.

• Annual CDT Updates: Follow ADA’s CDT updates every year to ensure correct and current code usage.
• Regulatory Compliance: Adhere to HIPAA, payer policies, Medicaid, and Medicare guidelines when coding and submitting claims.
• Thorough Documentation: Record every service, procedure date, tooth numbers, surfaces, and materials used for accurate claims.
• Pre-Authorization Required: Obtain prior authorizations when required, especially for prosthodontics, implants, orthodontics, and sedation procedures.
• CDT Standardization: Use ADA CDT codes to standardize procedure reporting. These codes describe a procedure that’s been performed, not what’s covered in a plan.
• Use of Modifiers: Apply CDT-approved modifiers only when procedures involve exceptions, multiple surfaces, or unusual circumstances.
• Diagnostic Pairing: Pair CDT codes with ICD-10-CM diagnoses when needed, especially for medically-linked procedures.
• Bundling Rules: Avoid unbundling. Do not bill separately for components already included in a comprehensive code.
• Ethical Coding: Select codes based on procedures performed. Don’t try to use other codes that may offer higher reimbursements, and avoid upcoding or undercoding.
• Audits and Verification: Maintain accurate records for audits. Periodic review helps prevent compliance issues and denials.

Best Practices for Efficient Dental Coding

Conduct Staff Training

Train your team regularly and educate them about the latest coding changes by the ADA. Since these codes are annually updated, it’s crucial to know these codes.

Equip your staff with ADA resources like coding manuals, guides, and webinars, making it easier for them to adopt new codes and subsequently prevent claim denials. 

For example, ADA has added a new code D5940 for fabricating a removable partial prosthesis (a denture or similar appliance) for the maxillary (upper) arch in its latest 2026 update. Previously, these services were covered in codes like D5211 or D5213, but now it has a new code, which must be used in 2026. 

Perform Frequent Audits

Performing dental billing audits helps you evaluate previously billed claims, so you catch errors and prevent future mistakes.

For instance, reviewing past claims may reveal repeated misselection of D1110 versus D1120. Both these codes are used for prophylaxis, but D1110 is used for adults, while D1120 is used for children.

Use Procedure Cheat-Sheets

Create quick-reference sheets for commonly performed procedures. For example, while coding, your staff can quickly reference that the CDT D0220 is an intraoral periapical radiograph. As a result, they can enter the proper code on the spot, thus reducing mistakes and speeding up claim submissions during busy patient visits.

Pre-Authorization for Expensive Procedures

Obtain prior authorization from insurance companies for costly treatments such as implants, orthodontics, or sedation. For instance, a D6010 implant may require approval from Delta Dental before placement to ensure coverage and prevent denied claims.

EHR Integration with CDT

Implement your electronic health record (EHR) systems with built-in CDT code selection. These systems reduce manual errors and automatically link codes to documentation and billing, improving accuracy and efficiency.

Outsource Dental Billing and Coding

Since dental coding has a huge impact on the accuracy of claim submissions and subsequent reimbursements, it’s crucial to ensure that procedures are coded precisely. 

A major way to do so is to outsource your billing and coding services to a reliable organization like TransDental. These billing companies employ trained dental billers and coders. Whether it’s mastering dental billing terminology or adapting to latest ADA updates and requirements, these experts enhance their knowledge and put it into action efficiently. These billers are also well-aware of the policies of each payer and state, allowing your coding workflows to stay compliant.

Moreover, outsourcing billing and coding reduces workload for your staff, minimizes human errors, and automates processes to ensure time-consuming tasks are completed in seconds.

Future of Dental Coding and Automation in 2026 and Beyond

CDT Code Evolution and Digital Dentistry

The ADA’s CDT 2026 reflects advances in digital workflows and dental technology. New codes, like D0802 (3D dental surface scan – indirect) and D2991 (hydroxyapatite regeneration medicament), standardize documentation for procedures involving 3D printing, digital scans, and regenerative materials.

For example, in the future, D0802 can be used to document a lab-fabricated digital crown for the scan, ensuring accurate claims submission. These updates allow your practice to leverage the latest technology for efficiency in diagnosis and treatments, while ensuring maximum reimbursements.

Artificial Intelligence and Predictive Analysis in Coding

AI is increasingly applied to automate CDT code selection, audit claims, and flag errors before submission. Tools analyze X-rays for caries detection, assess documentation completeness, and suggest codes based on clinical findings.

Moreover, predictive analytics flag inconsistencies, mismatched tooth numbers, or missing surfaces, helping prevent denials and speeding up reimbursement.

For example, an AI-assisted software can detect a molar lesion on a radiograph and recommend D2392 (resin-based composite, two surfaces, posterior), reducing human coding errors and preventing undercoding. Predictive analytics further identifies claims likely to be denied, improving workflow efficiency.

Teledentistry Coding and Policy Standardization

Standardized codes like D9995 (synchronous) and D9996 (asynchronous) are now widely used for teleconsultations. Place of Service (POS) codes, such as 02 or 10, ensure proper reimbursement and compliance. 

ADA policy allows teledentistry visits to be reimbursed, just like in-practice care, when the standard of care is met.

For example, a virtual consultation for postoperative implant check can be billed with D9995 + D6010 (implant placement follow-up) and POS code 10 for home telehealth, and sent for claim submission.

Medical-Dental Integration and Cross-Coding

Dentists increasingly submit claims to medical insurers using CPT and ICD-10-CM codes for systemic conditions like TMJ disorders or sleep apnea. Preventive procedures for high-risk patients, such as D1354 (silver diamine fluoride) or D1352 (preventive resin restoration), are linked to medical necessity to maximize reimbursement.

For example, a patient with high caries risk and a history of systemic disease may receive D1354 while the claim includes ICD-10-CM K02.53 (dental caries on pit and fissure surfaces, recurrent), ensuring coverage under medical insurance.

Resources, Cheat-Sheets, and Downloadable References

The table below describes some useful materials your billing teams and other departments need to stay current with CDT coding trends and usage requirements in 2026.

Conclusion

The accuracy of your claim submission and entire dental billing process relies on the CDT codes you use while filing claims. So, make sure that you either hire experienced coders or partner with well-known companies that can handle your billing and coding very well. Nowadays, it’s important to leverage technology while staying compliant with payer and state-specific coding requirements. Following these best practices reduces claim denials and ensures faster reimbursements, driving revenue growth for your dental practice.

Frequently Asked Questions (FAQs)