Insurance term
CDT Code
Definition
A CDT code is a five character procedure code (the letter D followed by four digits) from the Code on Dental Procedures and Nomenclature, maintained by the American Dental Association.
Why it matters for the front desk
Every procedure on a dental claim is reported with a CDT code, the HIPAA standard code set for dental procedures. The ADA updates the code every year, adding, revising and deleting codes, with changes taking effect on January 1. A claim that uses a deleted code, or the wrong code for the documented treatment, gets rejected or underpaid, so update fee schedules and practice software each January.
Related terms
- Claim Narrative A claim narrative is a short written explanation sent with a claim to show why a procedure was needed.
- Clearinghouse A clearinghouse is a company that passes electronic claims, eligibility checks and payment information between a dental practice and insurance payers.
- Downgrade (Alternate Benefit) A downgrade, or alternate benefit, is a plan rule that pays for a less expensive treatment than the one performed.