CDT Dental Codes: Documentation Rules & Denial Notes

The CDT codes dental teams bill daily — with the narrative requirements, frequency limits, and plan-clause traps that cause dental denials.

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CodeProcedure (Plain English)Documentation, Frequency & Denial Notes
Diagnostics & Preventive (D0xxx–D1xxx)
D0120Periodic oral evaluation (recall exam)Typically 2/year frequency limit. Cannot bill same day as D0150 for same patient.
D0150Comprehensive oral evaluation (new/established after 3 yrs)Usually 1 per provider per 3 years — billing it at every recall gets flagged fast.
D0140Limited evaluation, problem-focused (emergency exam)Pairs with the emergency treatment code; some plans bundle if definitive treatment same day.
D0220 / D0230Periapical X-ray, first / each additionalWatch total X-ray billing against the FMX allowance — multiple PAs + bitewings may auto-recode to D0210 (and pay less).
D0274Bitewings, four filmsFrequency-limited (commonly 1/year adult). Age rules for film counts.
D0210Full-mouth X-ray series (FMX)Commonly 1 per 3–5 years. FMX and pano (D0330) often share a frequency bucket — check before taking both.
D1110Adult prophylaxis (cleaning)2/year typical. The D1110-vs-D4346/D4910 decision after perio treatment is the top hygiene coding error — perio patients move to D4910, and downgrading back needs documentation.
D1206 / D1208Fluoride varnish / topical fluorideAdult fluoride is commonly not covered — verify or collect; age limits on pediatric coverage.
Restorative (D2xxx)
D2391Composite filling, posterior, one surfaceSome plans downgrade posterior composites to amalgam rates (patient owes the difference — disclose upfront). Surface counts must match the chart.
D2740Crown, porcelain/ceramicNarrative + pre-op X-ray nearly always required: existing restoration >50%, fracture lines, cusp coverage need. 5–8 year replacement clauses; verify seat date vs prior crown.
D2950Core buildup, including pinsThe most-denied restorative code: plans consider it inclusive without documentation of insufficient remaining structure. Bill with the crown, not before.
D2954Prefabricated post and coreRequires prior endo; plans check RCT history on the tooth.
Endodontics (D3xxx)
D3310 / D3320 / D3330Root canal: anterior / premolar / molarWorking-length X-rays support the claim. Retreatment (D3346–D3348) needs a narrative on why the original failed.
D3220Therapeutic pulpotomyPrimarily pediatric; billing with same-day RCT start on the same tooth denies as inclusive.
Periodontics (D4xxx)
D4341Scaling & root planing (SRP), 4+ teeth per quadrantThe classic documentation denial: needs perio charting with 4mm+ pockets, radiographic bone loss, and tooth counts per quadrant. Most plans limit 2 quadrants/visit and expect a re-eval before D4910.
D4342SRP, 1–3 teeth per quadrantTooth numbers required on the claim; billing D4341 when only 3 teeth qualify is the audit pattern plans mine for.
D4346Scaling with generalized moderate/severe gingival inflammationThe bridge code between prophy and SRP — no bone loss, but bleeding/inflammation documented. Not billable same day as D1110 or SRP.
D4910Periodontal maintenanceOnly after completed SRP/perio surgery, typically 3–4/year alternating rules with D1110 vary by plan. Plans deny D4910 with no perio history on file.
Oral Surgery (D7xxx)
D7140Simple extraction, erupted toothUpcoding D7140 to D7210 without documented bone removal/sectioning is the extraction audit trigger.
D7210Surgical extraction requiring bone removal or sectioningNote must describe flap, bone removal, or sectioning. X-ray supports.
D7240Full bony impaction removalPanoramic evidence of impaction depth. Third-molar age limits on some plans; medical-plan cross-coding sometimes pays better — check both benefits.
Prosthodontics & Implants (D5xxx–D6xxx)
D5110 / D5120Complete denture, upper / lower5–10 year replacement clauses; verify prior denture history. Adjustments within 6 months usually inclusive.
D6010Implant body placement, endostealMissing tooth clause central: extraction date vs coverage effective date decides everything. Many plans still exclude implants entirely — verify and estimate in writing.
D6058Abutment-supported porcelain/ceramic crownImplant crown coding must match the abutment codes billed; mixing implant and conventional crown codes denies.
D6740Bridge retainer crown, porcelain/ceramicMissing tooth clause + abutment tooth condition narrative. Plans compare against less-costly-alternative (partial) provisions.
Adjunctive (D9xxx)
D9110Palliative treatment of pain, minor procedurePer-visit code; needs the problem and treatment noted. Not billable with definitive treatment of the same tooth same day.
D9230 / D9243Nitrous oxide / IV sedation per 15-minSedation coverage is plan-by-plan and often excluded — verify or collect. Time units documented in the record.
D9944–D9946Occlusal guards (hard/soft, full/partial arch)Bruxism documentation; many plans limit 1 per 3–5 years or exclude. Medical cross-coding possible for TMD cases.

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About This Reference

CDT codes and nomenclature are copyright the American Dental Association; descriptions here are plain-English paraphrases for education, not official descriptors. Frequency limits and clauses summarized reflect common plan behavior — the patient's specific plan document controls. Updated July 2026. See the full dental billing guide.

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