March 2017-CMC Page 1 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC) Request 1 Inventory # 1. CID 2017_aapd1_2015Oct27 Action Add X Procedure Code / Category Affected (Revisions and Deletions Only) Dxxxx Submitted By American Academy of Pediatric Dentistry (AAPD) Revise Delete Nomenclature / Title (additions in blue underline; deletions in red strike-through) dental case management – appointment compliance and transportation facilitation services Descriptor / Text (additions in blue underline; deletions in red strike-through) Individualized efforts to assist patients in maintaining scheduled appointments by solving for them transportation challenges or other barriers. Code Maintenance Committee Action (e.g., Motion to Accept) 2 Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other” Yea Accept Nay Decline Abstain Other 3
Transcript
March 2017-CMC Page 1 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 1. CID 2017_aapd1_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
American Academy of Pediatric Dentistry (AAPD)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
dental case management – appointment compliance and transportation facilitation services
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Individualized efforts to assist patients in maintaining scheduled appointments by solving for them transportation challenges or other barriers.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 2 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 2. CID 2017_aapd2_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
American Academy of Pediatric Dentistry (AAPD)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
dental case management – care coordination
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Assisting and participating in decisions regarding the navigation and coordination of oral health care services across multiple providers, provider types, specialty areas of treatment, health care settings, health care organizations and payment systems requiring experience or expertise beyond that possessed by the patient where additional time and resources are expended.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 3 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 3. CID 2017_aapd3_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
American Academy of Pediatric Dentistry (AAPD)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
dental case management – motivational interviewing
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Patient-centered, personalized counseling using the method known as Motivational Interviewing (MI) to identify and modify behaviors interfering with optimal oral health outcomes. This is a separate service from traditional nutritional or tobacco counseling.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 4 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 4. CID 2017_aapd4_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
American Academy of Pediatric Dentistry (AAPD)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
dental case management – patient education and oral health literacy
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Individual, customized communication of information to assist the patient in making appropriate health decisions explained in a manner acknowledging economic circumstances and different cultural beliefs, values, attitudes, traditions and language preferences, and adopting information and services to these differences, which requires the expenditure of time and resources beyond that of the common case presentation.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 5 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 5. CID 2017_davis1_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
secure bond
Descriptor / Text (additions in blue underline; deletions in red strike-through)
A microfil flowable composite .5mm placed on the IDS layer. This layer acts as a fail safe mechanism to protect the bond and the tooth. Bonds are so strong that if the adhesive ceramic restoration is bonded to the bond and the restoration fails the bond would not fail the tooth would fracture. Creating a secure bond allows for a manageable repair.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 6 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 6. CID 2017_davis6_2015Oct30 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
crack support for cracks that cannot removed completely in vital teeth
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Some cracks into dentin go vertically toward the pulp so tooth anatomy dictates how far you can go. Less than 5mm from occlusal table and 3mm from the periphery of the tooth on clinically vital tooth. If the crack still is present and going any further would expose the pulp then proper advanced adhesive protocols should be followed with caries removal, creating a bondable surface, CHX, IDS, secure bond and lay fibers over the crack to support the crack. Then the tooth can be restored with SRDC, or an adhesive biobase with an indirect adhesive restoration.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 7 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 7. CID 2017_davis5_2015Oct26 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
caries dye (for precise removal of infected dentin)
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Caries dye is applied to infected dentin and the infected dentin is removed and the affected dentin can be left when it approaches creating an exposure into an asymptomatic pulp. However, healthy non-infected dentin should be obtained in the periphery of the preparation to assure a strong dentin bond. This technology allows a clinical end-point to caries removal That is visual and clinically significant to obtain a strong dentin bond.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 8 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 8. CID 2017_davis7_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
laser florescence
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Gives digital readings to refine the end point of caries removal, once again to obtain a better dentin bond. The laser is not measuring bacteria but the by products of germ active like porpherins. This is evidence based.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 9 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 9. CID 2017_davis2_2015Oct30 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
crack into dentin removal
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Previously restored teeth and generally with alloys sometimes have symptoms of sharp pain upon biting and/or hot and cold sensitivity not necessarily mutually inclusive. The hydrodynamic dentinal pain that is generated is due to a crack into dentin. And prior to restoring a tooth it must be identified usually with high magnification and removed if possible without exposing the pulp. Once removed the tooth should then be restored using all the biomimetic protocols.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 10 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 10. CID 2017_davis3_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
ids (immediate dentin sealing)
Descriptor / Text (additions in blue underline; deletions in red strike-through)
IT is proven through research that when cut dentin is immediately bonded or sealed that the bond strength increase by another 30%. Therefore for direct and indirect biomimetic restorations there is a benefit. It protects the pulp which has been described as the brain of the tooth.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 11 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 11. CID 2017_davis4_2015Oct29 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
srdc (stress reduced direct composite)
Descriptor / Text (additions in blue underline; deletions in red strike-through)
An advanced adhesive restoration that is stress reduced using the science of modern adhesives and materials that can be done instead of a traditional mechanically retained crown. The protocol uses, caries die, laser fluorescence, MMP neutralization, AA, IDS, secure bond, fibers, incremental placement to control C-factor stresses, Bonding and restoring dentin first incrementally and then allowing those bonds to mature or decoupling with time and then restoring the enamel incrementally usually on cusp at a time without connecting to the other cusps to decrease the C-factor stresses. The benefit of a SRDC may never need a crown or onlay.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 12 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 12. CID 2017_davis8_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
air abrasion – import for increasing bond strength
Descriptor / Text (additions in blue underline; deletions in red strike-through)
A technology that is used to improve the surface of dentin, ceramics, metals for improving the bond strength of the surface to which adhesives and composites are being bonded. Research shows that by doing this the bond strength is improved by 30%.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 13 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 13. CID 2017_davis9_2015Oct29 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
deep margin elevation for direct and indirect adhesive composite restorations
Descriptor / Text (additions in blue underline; deletions in red strike-through)
When disease or previous restoration go below the gingival margin this technique allows the dentist to clinically adhesively raise the margin for better impressions for an indirect restoration or to continue to restore the biological rim or a SDRC (stress reduced direct composite) Codes for Caries dye, Laser fluorescence, MMP neutralization, AA, IDS apply to this treatment.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 14 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 14. CID 2017_davis10_2015Oct28 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
adhesive biobase for tooth preparation for and indirect adhesive restoration
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This is a restoration to create a foundation for and indirect adhesive biomimetic inlay, onlay, full onlay, partial onlay. Caries dye, laser fluorescence, AA, MMP neutralization, IDS, secure bond and fibers and possibly deep margin elevation are used to create a strongly bonded composite foundation. Since the retention of the biobase is adhesive and not mechanical the final restoration is also adhesive and not mechanical. Enamel margins are then beveled and the composite margins are defined. Then and indirect impression is taken, or scan. There is no need for temporization because the dentin is sealed and protected. Block out could be bonded interproximally to prevent movement if the restoration is not fabricated at the time of adhesive biobase.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 15 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 15. CID 2017_davis11_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
polyethylene woven fiber placement
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Research shows that when a polyethylene woven fibers is placed into a composite filling on the wall and floor we can control C-factor forces and fiber use at the interface affects the microtensile bond strength to dentin.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 16 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 16. CID 2017_davis12_2015Oct28 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Scott Davis Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
mmp neutalization
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Matrix Metallo-Protenases or MMPs have been shown to degrade dentin bonds over time and therefore they need to be neutralized. Some dentin bonding systems because of their proprietary chemistry automatically neutralize the MMPs. However, it the bonding system does not then they can be neutralized by placing a 2% CHX Chlorhexidine solution on dentin for 30 seconds.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 17 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 17. CID 2017_abrams1_2015Oct30 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Abrams Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
adjunctive pre-diagnostic method/procedure for quantifying changes in structure of enamel, dentin, cementum for diagnosing caries
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This code will be used to cover a procedure using an instrument calibrated to quantify structural and mineral changes in tooth structure, to assist in diagnosing and monitoring early and advanced caries.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 18 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 18. CID 2017_abrams2_2015Oct30 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Abrams Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
examination for quantifying changes in structure of teeth for assessing performance of remineralization agents
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This code will be used to cover the examination using any instrument that is calibrated to quantify structural and mineral changes in tooth structure to assist in assessing the need for and efficacy of a remineralization / preventive regimen and/or agent.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 19 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
distal shoe space maintainer – fixed – unilateral
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Fixed appliance extending subgingivally to guide the eruption of the first permanent molar. Initial fabrication and delivery. Does not include all ongoing follow-up, adjustments. Does not include replacement appliances.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 20 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
gathering and entering of diagnostic records to a cloud database
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Scanning and uploading patient diagnostic records for the real time retrieval by patient, specialist, insurance company, or law enforcement.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 21 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 21. CID 2017_friedel_2015Oct27 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Friedel Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
intraoral photographic image – infrared transillumination for capture of hard tissue pathology
Descriptor / Text (additions in blue underline; deletions in red strike-through)
None
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 22 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 22. CID 2017_smith_2015Oct23 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Smith Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
crown – ceramic with fluoride
Descriptor / Text (additions in blue underline; deletions in red strike-through)
A preventive procedure that restores a decayed tooth while also releasing fluoride to adjacent natural teeth on a long term basis. This procedure may be used to inhibit interproximal caries.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 23 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 23. CID 2017_grubb2_2014Dec02 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Grubb Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
crown removal
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Removal of an existing crown in order to prepare for a new crown.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 24 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 24. CID 2017_grubb1_2014Dec02 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Grubb Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
removal of fixed partial denture
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Removal of existing fixed partial denture in order to prepare for a new bridge, implant placement or extraction.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 25 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
pontic – large diastima the size of a tooth
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This is not used in the case of a tooth that has been extracted nor to be used in the case of an unerupted tooth but for use in a situation to close a diastima with a bridge when the diastima is between two adjacent teeth with sequential tooth numbers. Ex:
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 29 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 29. CID 2017_fuller1_2015Sep17 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Fuller Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
connective tissue graft around an implant
Descriptor / Text (additions in blue underline; deletions in red strike-through)
None
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 30 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 30. CID 2017_fuller2_2015Sep17 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Dr. Fuller Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
free gingival graft around an implant
Descriptor / Text (additions in blue underline; deletions in red strike-through)
None
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 31 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 31. CID 2017_miller_2015Jun12 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Ms. Miller Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
evidence based periodontal prophylaxis
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Evidence based periodontal “cleaning” for bone loss without periodontal involvement.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 32 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 32. CID 2017_aap2_2015Oct23 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
American Academy of Periodontology (AAP)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
scaling and debridement in the presence of inflammation or mucositis of a single implant, including cleaning of the implant surfaces, without flap entry and closure
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This procedure is not performed in conjunction with D1110 or D4910.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 33 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 33. CID 2017_cmcwg_2015Aug01 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
Code Maintenance Committee (CMC) Work Group
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation
Descriptor / Text (additions in blue underline; deletions in red strike-through)
The removal of plaque, calculus and stains from supra- and sub-gingival tooth surfaces when there is generalized moderate or severe gingival inflammation in the absence of periodontitis. It is indicated for patients who have swollen, inflamed gingiva, generalized suprabony pockets, and moderate to severe bleeding on probing. Should not be reported in conjunction with prophylaxis, scaling and root planing, or debridement procedures.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
CMC Work Group alternative to three tabled requests – see following inventory #s: 34, 35, and 36. Nay Decline
Abstain Other
3
March 2017-CMC Page 34 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 34. CID 2017_grill_2014Aug2 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Ms. Grill Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
scaling and debridement- light – 4 or more teeth per quadrant
scaling and debridement-medium – 4 or more teeth per quadrant
scaling and debridement-heavy – 4 or more teeth per quadrant
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Light: The removal of supra and subgingival plaque, calculus, and stains, when there is more than 5 surfaces of readily detectable calculus in the quadrant.
Medium: The removal of supra and subgingival plaque, calculus, and stains, when there is more than 10 surfaces of readily detectable calculus in the quadrant.
Heavy: The removal of supra and subgingival plaque, calculus, and stains, when there is more than 20 surfaces of readily detectable calculus in the quadrant.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Tabled from March 2015 CMC meeting. Nay Decline
Abstain Other
3
March 2017-CMC Page 35 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
scaling in the presence of gingival disease
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This procedure is intended for patients with plaque-induced gingival diseases in the absence of clinical attachment loss. It includes removal of the bacterial plaque, calculus from supragingival and subgingival regions, stains, and polishing the teeth. It is therapeutic, not prophylactic, in nature.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Tabled from march 2015 CMC meeting. Nay Decline
Abstain Other
3
March 2017-CMC Page 36 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 36. CID 2017_raffi_2014Oct30 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By Ms. Raffi Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
scaling performed in the presence of moderate to severe gingival inflammation
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Scaling performed in the presence of moderate to severe gingival inflammation with no clinical attachment loss (recession, bone loss, etc).
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Tabled from March 2015 CMC meeting. Nay Decline
Abstain Other
3
March 2017-CMC Page 37 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
spray and stretch technique to temporomandibular joint
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Vapocoolant spray and stretch therapy by applying a cold spray to affected muscles to decrease pain, reduce inflammation, and increase muscle relaxation.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 49 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
tens therapy to the temporomandibular joint
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Transcutaneous electrical nerve stimulation to produce muscle relaxation to reposition the mandible to the skull at the ideal neuromuscular position of occlusion.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 50 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 50. CID 2017_adacdbp_2015Oct15 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Adjunctive General Services
Submitted By
American Dental Association (ADA/CDBP)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
Anesthesia
Analgesia and Anxiolysis Procedures
D9210 local anesthesia not in conjunction with operative or surgical procedures
D9215 local anesthesia in conjunction with operative or surgical procedures
D9211 regional block anesthesia
D9212 trigeminal division block anesthesia
D9230 inhalation of nitrous oxide
Descriptor / Text (additions in blue underline; deletions in red strike-through)
None
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 51 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
Anesthesia
Anesthesia and Sedation Procedures
The following definition of start and end times is solely for the purpose of CDT Code selection, applicable to patient record-keeping and claim submission:
Anesthesia and Sedation procedures Start when the patient is being prepared in the operating room or equivalent area for induction of the anesthetic or sedative agent immediately prior to delivery of an operative procedure. Anesthesia and Sedation procedures End when the patient may be safely placed under post-operative supervision.”
The level of anesthesia is determined by the anesthesia provider’s documentation of the anesthetics effects upon the central nervous system and not dependent upon the route of administration.
D9219 evaluation for deep sedation or general anesthesia
D9223 deep sedation/general anesthesia – each 15 minute increment
D9243 intravenous moderate (conscious) sedation/analgesia – each 15 minute increment
D9248 non-intravenous conscious sedation
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Not applicable to this requested action.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 52 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
deep sedation/general anesthesia – each 15 minute increment
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Anesthesia time begins when the doctor administering the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains in continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients or duties.
The level of anesthesia is determined by the anesthesia provider’s documentation of the anesthetics effects upon the central nervous system and not dependent upon the route of administration
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 53 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
intravenous moderate (conscious) sedation/analgesia – each 15 minute increment
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Anesthesia time begins when the doctor administering the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains in continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients or duties.
The level of anesthesia is determined by the anesthesia provider’s documentation of the anesthetics effects upon the central nervous system and not dependent upon the route of administration.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 54 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
non-intravenous conscious sedation
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This includes non-IV minimal and moderate sedation.
A medically controlled state of depressed consciousness while maintaining the patient’s airway, protective reflexes and the ability to respond to stimulation or verbal commands. It includes non- intravenous administration of sedative and/or analgesic agent(s) and appropriate monitoring.
The level of anesthesia is determined by the anesthesia provider’s documentation of the anesthetic’s effects upon the central nervous system and not dependent upon the route of administration.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 56 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
other drugs and/or medicaments dispensed in the office for home use, by report
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Includes, but is not limited to oral antibiotics, oral analgesics, and topical fluoride dispensed in the office for home use; does not include writing prescriptions.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 57 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 57. CID 2017_adacdbp_2015Oct15 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
American Dental Association (ADA/CDBP)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
consultation with physician
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Treating dentist consults with physician concerning medical issues that may affect patient’s planned dental treatment.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 58 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 58. CID 2017_adacdbp_2015Oct15 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
American Dental Association (ADA/CDBP)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
laboratory processing of microbial specimen to include culture and sensitivity studies, preparation and transmission of written report
Descriptor / Text (additions in blue underline; deletions in red strike-through)
None
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 59 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
posterior-anterior or lateral skull and facial bone survey radiographic image
Descriptor / Text (additions in blue underline; deletions in red strike-through)
None
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 61 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 61. CID 2017_hammer1_2015Oct26 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D0230 Submitted
By Dr. Hammer Revise X
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
intraoral - periapical each additional radiographic image on a single date of service
Descriptor / Text (additions in blue underline; deletions in red strike-through)
None
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 62 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 62. CID 2017_hammer2_2015Oct26 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D0220 Submitted
By Dr. Hammer Revise X
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
intraoral - periapical first radiographic image on a single date of service
Descriptor / Text (additions in blue underline; deletions in red strike-through)
None
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 63 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 63. CID 2017_hammer3_2015Oct26 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D1110 Submitted
By Dr. Hammer Revise X
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
prophylaxis – adult age 14 or greater
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Removal of plaque, calculus and stains from the tooth structures in the permanent and transitional dentition. It is intended to control local irritational factors.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 64 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 64. CID 2017_hammer4_2015Oct26 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D1120 Submitted
By Dr. Hammer Revise X
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
prophylaxis – child age below 14
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Removal of plaque, calculus and stains from the tooth structures in the primary and transitional dentition. It is intended to control local irritational factors.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 65 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 65. CID 2017_nadp3_2015Oct30 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D4263 Submitted
By
National Association of Dental Plans (NADP)
Revise X
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
bone replacement graft – retained natural tooth – first site in quadrant
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This procedure involves the use of grafts to stimulate periodontal regeneration when the disease process has led to a deformity of the bone. This procedure does not include flap entry and closure, wound debridement, osseous contouring, or the placement of biologic materials to aid in osseous tissue regeneration or barrier membranes. Other separate procedures delivered concurrently are documented with their own codes. Not to be reported for an edentulous space or an extraction site.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 66 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 66. CID 2017_nadp_2015Oct30 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D4264 Submitted
By
National Association of Dental Plans (NADP)
Revise X
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
bone replacement graft – retained natural tooth – each additional site in quadrant
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This procedure involves the use of grafts to stimulate periodontal regeneration when the disease process has led to a deformity of the bone. This procedure does not include flap entry and closure, wound debridement, osseous contouring, or the placement of biologic materials to aid in osseous tissue regeneration or barrier membranes. This procedure is performed concurrently with one or more bone replacement grafts to document the number of sites involved. Not to be reported for an edentulous space or an extraction site.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 67 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 67. CID 2017_aap1_2015Oct23 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D4274 Submitted
By
American Academy of Periodontology (AAP)
Revise X
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
distal or proximal mesial/distal wedge procedure, single tooth (when not performed in conjunction with other surgical procedures in the same anatomical area)
Descriptor / Text (additions in blue underline; deletions in red strike-through)
This procedure is performed in an edentulous area adjacent to a periodontally involved tooth. , Gingival incisions are utilized to allowing allow removal of a tissue wedge to gain access and correct the underlying osseous defect and to for debridement, permit close flap adaptation, and reduce pocket depths.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 68 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 68. CID 2017_nadp2_2015Oct30 Action
Add X Procedure Code / Category Affected
(Revisions and Deletions Only)
Dxxxx Submitted
By
National Association of Dental Plans (NADP)
Revise
Delete
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
removal of impacted tooth – partial or complete bony
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Part, most, or all of crown covered by bone; requires mucoperiosteal flap elevation and bone removal.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 69 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 69. CID 2017_nadp5_2015Oct30 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D7230 Submitted
By
National Association of Dental Plans (NADP)
Revise
Delete X
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
removal of impacted tooth – partially bony
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Part of crown covered by bone; requires mucoperiosteal flap elevation and bone removal.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
Yea Accept
Nay Decline
Abstain Other
3
March 2017-CMC Page 70 of 70 CDT-2017 Substantive Action Request Inventory CDBP Code Maintenance Committee (CMC)
Request 1
Inventory # 70. CID 2017_nadp6_2015Oct30 Action
Add Procedure Code / Category Affected
(Revisions and Deletions Only)
D7240 Submitted
By
National Association of Dental Plans (NADP)
Revise
Delete X
Nomenclature / Title (additions in blue underline; deletions in red strike-through)
removal of impacted tooth – completely bony
Descriptor / Text (additions in blue underline; deletions in red strike-through)
Most or all of crown covered by bone; requires mucoperiosteal flap elevation and bone removal.
Code Maintenance Committee Action (e.g., Motion to Accept) 2
Vote Decision Remarks / Rationale for “Decline” / Explanation of “Other”
