COVID-19 Coding and Billing Interim Guidance : PPE
Hawaii Dental Service ( HDS )...................................................................................................................................... 13 Delta Dental of Arkansas ............................................................................................................................................ 13 Delta Dental of Rhode Island ...................................................................................................................................... 14 Delta Dental of Wyoming ............................................................................................................................................ 14 Delta Dental of Wisconsin ........................................................................................................................................... 14 Delta Dental of Iowa .................................................................................................................................................... 14 Delta Dental of South Dakota ( DDSD )........................................................................................................................ 15 Delta Dental of Tennessee .......................................................................................................................................... 15 Delta Dental of New Jersey ( DDNJ ) and Delta Dental of Connecticut ( DDCT ).......................................................... 15 Delta Dental of Michigan , Indiana & Ohio ................................................................................................................... 16
The American Dental Association recognizes the extraordinary circumstances dentists and their patients face as we navigate the COVID pandemic . The cost of infection control procedures has skyrocketed and dental offices are facing a significant financial challenge navigating this environment . Further , costs of personal protective equipment ( PPE ) including N95 masks , surgical masks , face shields , gowns and shoe covers , has increased due to supply shortages with prices variable across the nation . Operatory protective barriers , protective equipment for front office staff , additional disinfection protocols and other administrative or engineering controls ( e . g . isolation systems , air purifiers , filters , etc .) are adding overhead for dental offices . In this environment , the ADA has issued a Statement on Third Party Payer Reimbursement for Costs Associated with Increased Standards for Personal Protective Equipment ( PPE ). This guide provides additional information regarding coding and billing for PPE . In the long-term dentists whose overhead has remarkably changed , may choose to approach third party administrators to re-negotiate their fee schedules . The ADA has developed a guide on Handling Contract Negotiations .
Coding
As noted in the Statement on Third Party Payer Reimbursement for PPE the ADA is urging third party benefit programs to either :
( 1 ) Adjust the maximum allowable fees for all procedures or ( 2 ) Allow a standard fee per date of service per patient to accommodate the rising costs of PPE .
Prior to such adjustments taking effect , dental offices may wish to use CDT code “ D1999 - unspecified preventive procedure , by report ” to document and report the use and cost of additional PPE . Dentists can use this code once per patient visit / claim to attempt to cover the cost of PPE .
D1999 unspecified preventive procedure , by report Used for a procedure that is not adequately described by a code . Describe the procedure .
© 2020 American Dental Association All rights reserved . Last Reviewed : July 7 , 2020 2