Monday, January 23, 2023

ADA Amends the CDT Defintion of Ceramic - Printed Restorations are Now Billable


In the world of healthcare, it is extremely important to bill for what you do.  In dentistry that is especially true when it comes to billing for fixed prosthetics (that is crowns & bridges if you don't speak dentistry).  There are several CDT Codes that apply toward the materials used to create fixed prosthetics and it is important to use the correct one.

That is one of the reasons why the new definition from the ADA is so ground breaking.  Up until this point, there really wasn't a code that would allow for billing (and thus insurance reimbursement) for a crown that was created by a 3D printer.

3D printing in dentistry has been steadily growing for at least the last 5 years.   I began to really notice offices exploring this technology during the 2020 Covid lockdown which allowed me more time online to explore trends, comments, info from manufacturers, and other sources of data.

The Holy Grail of 3D printing has always been permanent restorations.  Now don't get me wrong, 3D printing has multiple applications in dentistry and all of them are terrific.  We have been using 3D printers in my office for years and we absolutely *love* what we can accomplish with them.  However, that being said, the really big deal is to print permanent restorations. 

About a year ago, resins started to appear on the market that could be used to do just that.  At long last, resins were available to allowed doctors to print indirect fixed prosthetics.  The only problem in that equation was the one that dealt with the doctor getting paid for it.  A doctor can use whatever material they feel is the best or appropriate for a given situation, but third party payers (meaning insurance companies) will only reimburse for certain codes.  Without going into great detail about the entire billing procedure, suffice it to say that CDT (Common Dental Terminology) codes are intrinsic to the payment process when dealing with dental insurance.  So, while the doctor could create a printed restoration, they couldn't get paid for it.  The patient, of course, could choose to pay out of pocket for that restoration, but that sort of defeats the entire idea of having dental insurance in the first place.

That's why this amendment to the definition of "Ceramic" is so exciting.  

According to SprintRay:

In the past, “Ceramic” was defined as: “…pressed, fired, polished or milled materials containing predominantly inorganic refractory compounds including porcelains, glasses, ceramics and glass-ceramics.” The new definition eliminates “pressed, fired, polished or milled materials”. The deletion of the manufacturing criteria from the definition of porcelain/ceramic opens the door to permanent restorations printed with predominantly inorganic refractory compounds.

This means that now 3D printing is finally accepted for billing purposes.

SprintRay is a great 3D printing company that deals exclusively with the dental industry.  I've been working with them since I started 3D printing in my office and have had a great experience with them.  If you'd like to learn more about this whole change of CDT definition and what it means, SprintRay has a page dedicated to this info.  Check it out by following this link.   Exciting things are about to happen!

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