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A Comprehensive Guide to ADA (American Dental Association) Billing Codes

Jon M, DDS
Updated
The information provided in this article is intended for use by licensed dental and healthcare professionals only, for informational purposes only, and does not constitute medical or dental advice or replace clinical judgment. The treating clinician bears sole responsibility for all diagnostic and therapeutic decisions made in connection with patient care.

Dandy has compiled and offers this billing code reference guide to assist your practice in billing for our lab products.

  • Note: Dandy is not a specialist in American Dental Association coding and cannot provide codes not mentioned here or respond to inquiries regarding any ADA codes. 

Crown and Bridge

(Full-contour Zirconia, Zirconia Translucent Aesthetic, Porcelain Fused to Zirconia, eMax, eMax Layered)

Crown Bridge Abutment Bridge Pontic Code Description
D2740 D6740 D6245 porcelain or ceramic substrate; pontic: porcelain or ceramic

 

Inlay and Onlay

(Full-contour Zirconia, Zirconia Translucent Aesthetic, Porcelain Fused to Zirconia, eMax, eMax Layered)

Code Inlay or Onlay Code Description
D2610 Inlay 1 Surface Inlay: porcelain or ceramic; one surface
D2620 Inlay 2 Surfaces Inlay: porcelain or ceramic; two surfaces
D2630 Inlay 3+ Surfaces Inlay: porcelain or ceramic; three or more surfaces
D2642 Onlay 2 Surface Onlay: porcelain or ceramic; two surfaces
D2643 Onlay 3 Surfaces Onlay: porcelain or ceramic; three surfaces
D2644 Onlay 4+ Surfaces Onlay: porcelain or ceramic; four or more surfaces
D2962 Veneer Labial veneer (porcelain laminate): Laboratory

 

Full Metal

(Full Metal Non-Precious, Full Metal Semi-Precious Noble, High Noble Yellow Gold, High Noble Rich Yellow Gold, High Noble White Gold)

Code Crown
D2750 Crown: porcelain fused to high-noble metal
D2751 Crown: porcelain fused to predominantly base metal
D2752 Crown: porcelain fused to noble metal
D2790 Crown: full-cast high noble metal
D2791 Crown: full-cast, predominantly base metal

D2792

 Crown: full-cast noble metal

 

Implant

(Prefabricated titanium abutment, custom titanium or zirconia abutments, and abutment crown)

Code Implant
D6057 Custom Abutment Titanium
D6057 Custom Abutment Zirconia
D6056 Ti - Base/ Prefabricated abutment
D6058 Abutment-supported porc/cer crown

 

Surgical Appliances

(Tissue or tooth-borne surgical guides)

Code Procedure
D7290 Fabrication of a Surgical Guide
D6194 Placement of a Surgical Guide
D6190 Radiographic or Surgical Index
D7971 Tooth or Tissue-Supported Surgical Guide
D7286 Placement of guide for dental implant surgical stent
D7971 (CAD/CAM) surgical guide for dental implant placement
D9944 Occlusal orthotic device, surgical guide
D5934 Mandibular resection prosthesis with guide flange
D5935 Mandibular resection prosthesis without guide flange
D3432 Guided tissue regeneration, resorbable barrier, per site, in conjunction with periradicular surgery
D4266 Guided tissue regeneration, natural teeth—resorbable barrier, per site
D6106 Guided tissue regeneration (resorbable barrier) per implant

 

Dentures

(Signature Denture, Aesthetic Denture)

Code Procedure
D5120 Mandibular Complete Denture
D5110 Maxillary Complete Denture
D5140 Mandibular Immediate Denture
D5130 Maxillary Immediate Denture
D5863 Complete Maxillary Over-Denture
D5865 Complete Mandibular Over-Denture
D5860 Over-denture Completed by Report (Generic Code)
D5410 Adjust complete denture (maxillary)
D5411 Adjust complete denture (mandibular)

 

Partials

(Metal (Ti or CrCo),  Flexible (TCS / Valplast, Duraflex), Acetal (Milled Disc, Lucitone 199), Hybrid (Metal (Ti) + Flexible))

Material Code Description
Flexible and Acetal (Bilateral, Straight to Finish) D5225 Maxillary partial denture: flexible base (including retentive/clasping materials, rests, and teeth)
D5226 Mandibular partial denture: flexible base (including retentive or clasping materials, rests, and teeth)
Maxillary Partial Denture Cast Metal Framework and Hybrid (Bilateral, Straight-to-Finish) D5213 Maxillary partial denture: a cast metal framework with resin denture bases (including any conventional clasps, rests, and teeth)
D5214 Mandibular partial denture: a cast metal framework with resin denture bases (including any conventional clasps, rests, and teeth)
Acrylic (Flipper) Partial Denture D5227 Immediate maxillary partial denture: flexible base (including any clasps, rests and teeth)
D5228 Immediate mandibular partial denture: flexible base (including any clasps, rests and teeth)

For Unilateral Flexible

 

 D5284 Removable unilateral partial denture: one-piece flexible base (including retentive/clasping materials, rests, and teeth) per quadrant
D5286 Removable unilateral partial denture: one piece resin (including retentive and clasping materials, rests, and teeth) per quadrant
For Unilateral Cast Metal or Hybrid D5282 Removable unilateral partial denture: one piece cast metal (including retentive and clasping materials, rests, and teeth), maxillary
D5283 Removable unilateral partial denture: one piece cast metal (including retentive and clasping materials, rests, and teeth), mandibular

Adjustments

 

 D5421 Adjust partial denture—maxillary
D5422 Adjust partial denture—mandibular
Add Ons D5876 Add metal substructure to acrylic full denture (per arch)

 

Occlusal Guards

(Softening Thermodynamic 3D-printed, Layered thermodynamic hard-soft, Astron, NTI, Sports guard)

Code Description
D9940 Occlusal Guard by Report
D9941 Fabrication of Athletic Mouthguard

 

Orthodontics

(Dandy On Demand, Dandy 20, Dandy Max, Clear Removable Retainer, Lingual Fixed Retainer, Hawley Retainer)

Code Description
D8090 Comprehensive Adult ortho
D8680 Orthodontic retention
D8040 Limited orthodontic treatment of adult dentition

 

Apnea (OSA)

(Preferred and Freedom)

Code Description
Medical codes (HCPCS codes):
E0486 Oral device or appliance used to reduce upper airway collapsibility, adjustable or non-adjustable, custom fabricated, includes fitting and adjustment.

 

K1027

 Custom-fabricated oral device or appliance used to reduce upper airway collapsibility for obstructive sleep apnea (OSA) without a fixed mechanical hinge, including fitting and adjustment.
Dental Codes: 
D9947 Custom sleep appliance fabrication and placement
D9948 Adjustment of custom sleep apnea appliance
D9949 Repair of custom sleep appliance
CPT home sleep study:
 
95800 Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, respiratory analysis (e.g., by airflow or peripheral arterial tone), and sleep time.
95801 Sleep study unattended with respiratory analysis.
95806 Sleep study, unattended, simultaneous heart rate recording, oxygen saturation, respiratory airflow, and respiratory effort.
G Home Sleep Study codes:
 
G0398 Sleep study, with a type II portable monitor; unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort, and oxygen saturation.
G0399 Sleep study with a type III portable monitor; unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate, and 1 oxygen saturation.
G0400 Sleep study with a type IV portable monitor; unattended; minimum of 3 channels.

 

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