b'FOR YOUR PRACTICEAsk the Coding CoachCDT 2023 changes that will affect periodontalAlso changed is the code for gingival irrigation, D4921. With practices a medicinal agent was added to the nomenclature and the descriptor was eliminated. Every Jan. 1 brings CDT updates for claims submissions. 2023 will bring significant code changes that will affectCode revisions in other categories which should be noted include periodontal procedures. This column will concentrate on theD0210 and D0709. These codes now have nomenclature ones that directly affect a periodontal practice.that states intraoralcomprehensive series of radiographic images, eliminating the term complete and adding In the 4000 periodontal category there are six revisions.comprehensive. The descriptor was revised by eliminating Two revisions eliminated the wording or externalthe number of teeth required and adding that the radiographic resorption from D4240 and D4241, the gingival flapimages should include the crowns and roots of all teeth, procedures. This was the result of endodontic codesperiapical areas, interproximal areas and alveolar bone including D3471, D3472, and D3473 being specific for rootedentulous areas. resorption involving anterior teeth, premolars, or molars. In the 6000 implant category of the code set, D6105 was Coding for guided tissue regeneration has always beenadded for removal of implant body not requiring bone removal confusing, since regardless of the situation when a barrieror flap elevation. membrane was used, whether surrounding a natural tooth, an implant, or an edentulous area, the periodontalAdditionally, D9110 was revised to change emergency codes of D4266 and D4267 were the only appropriateto palliative in the nomenclature, and the descriptor codes. New codes in the implant section, D6106 andwas completely revised to treatment that relieves pain D6107, are now used when barrier membranes are utilizedbut is not curative; service provided do not have distinct involving an implant. D7956 and D7957 indicate guidedprocedure codes. The code is also now per visit.tissue regeneration when used in an edentulous area.There are several other changes to CDT 2023; there are 22 For clarification and consistency, D4266 and D4267additions, 14 revisions, and 2 deletions in all. These can be were revised with the addition of natural teeth to bothfound in detail in the new CDT 2023 book published by the ADA. the nomenclature and descriptor. Another major changeIf you have any questions or need clarification about the use of involving barrier membranes is the revision of D4267,the new codes, the AAPs third-party specialist and Dr. Marie which now does not include removal of the non-resorbableSchweinebraten, the AAPs Insurance Consultant, are always membrane. This will be considered a separate procedureavailable to help. requiring a separate code. It also applies to the new codes D6107 and D7957 for non-resorbable barrier membranes. Removal of the non-resorbable membrane, whether involving natural teeth, implants, or edentulous areas, should be coded D4286. ADA CDT 2023 Code ChangesA significant change applies to D4355 full mouthTo view the details of the new and updated CDT codes debridement. Previously, no oral or periodontal evaluationthat go into effect on Jan. 1, 2023, go to AAP Connect could be performed on the same day as the debridement. Libraries AAP Member Resources Insurance The code was changed to allow a comprehensiveReimbursement and Third-Party Issues ADA CDT oral evaluation on the same day, which may include a periodontal screening only. However, a comprehensive2023 Changes. Be sure to review this resource periodontal evaluation must be done on a subsequentperiodically to stay up to date on procedure codes.visit. This change will enable certain providers, especially those who are treating patients under general anesthesia or seeing patients under unusual circumstances when subsequent appointments may be difficult to schedule, to proceed with needed restorative treatment after a diagnosisSubmit your third-party questions to insurance@is made.perio.org. Members with coding questions or difficulties with insurance claims can also contact the AAPs third-party specialist at 312-573-3241.AAP Periospectives| 23'