CDT code
A CDT code is the standard code for a dental procedure, published by the American Dental Association in the Current Dental Terminology code set. Each code starts with the letter D followed by four digits, such as D0120 for a periodic oral evaluation and D1110 for an adult cleaning. Offices use the codes on treatment plans and insurance claims.
Why it matters to the front desk
Every benefit an insurer pays is tied to a procedure code, so the right code on the treatment plan decides the coverage answer. The front desk uses the codes to look up what a plan says about a scheduled procedure, including the percentage covered and any frequency limit that applies to that code. A wrong or missing code is a common reason a claim is denied or paid at a lower rate.
The code set is maintained by the ADA and updated each year, so a code added in recent years may still be covered unevenly. Low-volume codes, such as certain preventive medicament applications, often have no benefit line at all in a payer's response, and the answer is to phone the payer. Offices can also create custom D-prefixed codes in Open Dental (for example D4999.3); Open Dental sends only the first five characters on an electronic claim.
Related terms
Insurance Verification
Checks a patient's dental insurance with the payer, for one patient or the whole day's schedule, and returns coverage and benefits in a summary you can download.
See how Insurance Verification works