COVID-19 Coding and Billing Interim Guidance : PPE
• During this time period , claims should be submitted with code D1999 and must include the primary service ( s ) performed .
Cigna
• Cigna will reimburse in-network providers in both PPO and Cigna Dental Care ® networks at $ 8 per claim , per date of service .
• The allowance is for claims processed between June 15 and July 31 , 2020 , and is limited to once per patient , per day . During this time period , claims should be submitted with code D1999 for reimbursement consideration .
• Reimbursement for dates of service on or after April 1 , 2020 , is limited to U . S . Commercial and Individual dental plans and may be excluded by certain clients .
• Standard policies regarding infection control remain in place as outlined in our Dental Office Reference Guides which are incorporated by reference into the provider agreement .
United Concordia ( UCCI )
• Allowing providers $ 10 per patient visit for dates of service from 5 / 1 / 2020-6 / 30 / 2020 to help cover the costs associated with purchasing masks , sterilization procedures , and other CDC requirements resulting from COVID-19 .
• This coverage will apply to United Concordia administered business only , including : PPO commercial , Medicare Advantage , TRICARE Dental Program ( TDP ), Active Duty Dental Program ( ADDP ), Federal Employees Dental and Vision Insurance Program ( FEDVIP ), Gateway Health Medicare and Medicaid and its partnership business .
• To align with ADA guidance , please use procedure code D1999 unspecified preventive procedure , by report .
• Claims must include procedure code D1999 to be eligible to receive payment for PPE .
• D1999 can be used once per patient visit to cover the additional costs for PPE .
Principal
• Offering a Personal Protective Equipment payment of $ 7 per patient for June – December 2020 for in-network dental providers and insured dental customers .
• This payment is intended to support our in-network dentists and keep member ’ s safe during this time .
• Charges for PPE are considered non-covered services . Any amount charged over $ 7.00 for Personal Protective Equipment is patient responsibility .
• The $ 7.00 payment does not apply to the member ’ s calendar year maximum benefit amount .
© 2020 American Dental Association All rights reserved . Last Reviewed : July 7 , 2020 7