The AAO commented on recent changes to the CDT code that caused issues with dental insurers and state Medicaid offices.
The American Association of Orthodontists commented on recent changes to the Code on Dental Procedures and Nomenclature and how they affected orthodontic practices.
In Fall 2020, the AAO polled members to gauge whether the CDT code met orthodontists’ needs.
Many respondents to the survey selected “Determining when a case is Limited vs. Interceptive” and “Determining when a case is Limited vs. Comprehensive” as 2 of their top 3 areas of concern with the code.
As a result, the AAO’s Council on Orthodontic Health Care advocated for changes that the ADA Code Maintenance Committee voted to approve. The committee deleted the Interceptive Orthodontic Treatment subcategory nomenclature, descriptor, and codes D8050 and D8060, and revised the definition of Limited Orthodontic Treatment.
As an unintended consequence of this change, some dental insurance companies and state Medicaid offices failed to adjust their adjudication processes and claims payments properly.
The AAO provided resources to members to demonstrate how the codes are intended to function, answer frequently asked questions, explain how to negotiate network provider agreements, and train employees on coding strategies.
The AAO stated that while it does not control insurers’ policies, the association is communicating with payers, expressing members’ concerns, and requesting they make necessary preparations.
“We understand that this decision has had adverse effects on some of our members’ practices, and we are working to rectify the situation,” the AAO said in a statement. “While the AAO cannot act unilaterally on behalf of our members to negotiate higher payments, we accept the responsibility for advocating on behalf of our members, and we are unconditionally committed to these efforts.”
AAO members can share their thoughts, opinions, and inquiries concerning CDT changes through the Dental Benefits Comment Box, participate in surveys, or contact their COHC representative.