Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 1 of 79 March 2015 CMC Meeting

Transcription

1 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 1 of 79 Inventory # 1. CID DIA-01 D0xxx Action Add Dr. Redwantz extra-oral complete series of radiographs the A radiographic survey of whole mouth. Yea 0 Accept The Code Maintenance Committee found that request describes a procedure that delivers the same radiographic Nay 21 Decline X information as a panoramic image. Submission documentation did not establish a need for a new CDT Code entry, and the procedure as described is appropriately documented with the following existing CDT Code: Abstain 0 Other D0330 panoramic radiographic image

2 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 2 of 79 Inventory # 2. CID DIA-11 D0210 Action Revise Dr. Dubowsky intraoral - complete series of radiographic images A radiographic survey of the whole mouth, usually consisting of periapical and posterior bitewing images intended to display the crowns and roots of all teeth, periapical areas and alveolar bone. Yea 0 Accept Nay 21 Decline X Abstain 0 Other The Code Maintenance Committee determined that the proposed wording change does not add clarity or improved understanding to the current CDT Code entry, as the word intraoral is widely used and understood, and is required to fully describe this procedure.

3 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 3 of 79 Inventory # 3. CID DIA-03 D0320 Action Delete AAMOR temporomandibular joint arthrogram, including injection None Yea 1 Accept Nay 20 Decline X Abstain 0 Other The Code Maintenance Committee determined that the CDT Code entry deletion is not justified, as information on the submission does not support the contention that the procedure is no longer in use or clinically inappropriate.

4 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 4 of 79 Inventory # 4. CID DIA-04 D0xxx Action Add AAOMR panoramic image optimization post-capture processing of maxillary and mandibular arch data Digital data processing of multiple image layers into a single panoramic projection. Yea 3 Accept Nay 18 Decline X Abstain 0 Other The Code Maintenance Committee is unable to discern the requestor s intentions from the submitted documentation, as there is neither a clear definition of post-capture processing nor a defined time-period between image capture and completion of the action.

5 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 5 of 79 Inventory # 5. CID DIA-05 D0xxx Action Add AAOMR extra-oral posterior dental radiographic image Image limited to exposure of complete posterior teeth in both dental arches. This procedure is the alternative to posterior intra-oral radiographs when the patient is unable to accept the intraoral imaging medium. The CMC addressed two descriptor amendments before the motion to accept DIA Delete the entire second sentence This procedure is the alternative to posterior intra-oral radiographs when the patient is unable to accept the intraoral imaging medium. Accept 19 Yea / 2 Nay / 0 Abstain 2. Add a replacement second sentence This is a unique image that is not derived from another image. Accept 21 Yea / 0 Nay / 0 Abstain Yea 21 Accept X Motion to accept as amended Nay 0 Decline Abstain 0 Other D0xxx extra-oral posterior dental radiographic image Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.

6 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 6 of 79 Inventory # 6. CID DIA-06 D0xxx Action Add Dr. Bieri extra-oral bitewing Digital radiograph taken extra-orally by panoramic machine in place of internal bitewing. Yea 0 Accept Decline in favor of Inventory # 5 DIA-05. Nay 21 Decline X Abstain 0 Other D0xxx extra-oral posterior dental radiographic image Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.

7 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 7 of 79 Inventory # 7. CID DIA-14 D0xxx Action Add Dr. Friedel panorex radiographic image (extra oral bite wings)- sectional view using vertical and horizontal collimated beam Limited unaltered view of bimaxillary posterior dentate area, with resolution for restorative services, includes tooth apices. Yea 0 Accept Decline in favor of Inventory # 5 DIA-05. Nay 21 Decline X Abstain 0 Other D0xxx extra-oral posterior dental radiographic image Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.

8 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 8 of 79 Inventory # 8. CID DIA-07 D0xxx Action Add CDBP extra-oral image unilateral None Yea 0 Accept Submitter withdraws in favor of Inventory # 5 DIA-05. Nay 0 Decline Abstain 0 Other X D0xxx extra-oral posterior dental radiographic image Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.

9 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 9 of 79 Inventory # 9. CID DIA-08 D0xxx Action Add CDBP extra-oral image bilateral None Yea 0 Accept Submitter withdraws in favor of Inventory # 5 DIA-05. Nay 0 Decline Abstain 0 Other X D0xxx extra-oral posterior dental radiographic image Image limited to exposure of complete posterior teeth in both dental arches. This is a unique image that is not derived from another image.

10 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 10 of 79 Inventory # 10. CID DIA-09 D0340 Action Revise AAMOR 2D cephalometric radiographic image acquisition, measurement and analysis Image of the head made using a cephalostat to standardize anatomic positioning, and with reproducible x-ray beam geometry. Multiple images may be acquired to enable the included cephalometric measurement and analysis. The CMC approved one amendment to the proposed descriptor (above): Delete the entire second sentence ( Multiple images may be acquired to enable the included cephalometric measurement and analysis.) 21 Yea / 0 Nay / 0 Abstain Yea 21 Accept X Motion to accept as amended: Nay 0 Decline Abstain 0 Other D0340 2D cephalometric radiographic image acquisition, measurement and analysis Image of the head made using a cephalostat to standardize anatomic positioning, and with reproducible x-ray beam geometry.

11 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 11 of 79 Inventory # 11. CID DIA-10 D0250 Action Revise AAMOR extra-oral first 2D projection radiographic image created using a stationary radiation source, and detector These images include, but are not limited to: Lateral Skull; Posterior-Anterior Skull; Submentovertex; Waters; Reverse Tomes; Oblique Mandibular Body; Lateral Ramus. Yea 21 Accept X Nay 0 Decline Abstain 0 Other

12 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 12 of 79 Inventory # 12. CID DIA-12 D0250 Action Delete CDBP extraoral first radiographic image None Yea 0 Accept Withdrawn in favor of Inventory # 11 DIA-10. Nay 0 Decline Abstain 0 Other X D0250 extra-oral first 2D projection radiographic images created using a stationary radiation source, and detector These images include, but are not limited to: Lateral Skull; Posterior-Anterior Skull; Submentovertex; Waters; Reverse Tomes; Oblique Mandibular Body; Lateral Ramus.

13 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 13 of 79 Inventory # 13. CID DIA-13 D0260 Action Delete CDBP extraoral each additional radiographic image None Yea 0 Accept Nay 0 Decline Abstain 0 Other X Withdrawn in favor of Inventory # 14 DIA-02 D0260 extraoral each additional radiographic image

14 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 14 of 79 Inventory # 14. CID DIA-02 D0260 Action Delete AAOMR extraoral each additional radiographic image None Yea 21 Accept X Nay 0 Decline Abstain 0 Other

15 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 15 of 79 Inventory # 15. CID DIA-15 D0xxx Action Add DDPA collection and preparation of genetic sample material for laboratory analysis and report None Yea 18 Accept X Nay 2 Decline Abstain 1 Other

16 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 16 of 79 Inventory # 16. CID DIA-16 D0421 Action Revise DDPA genetic test for susceptibility to oral diseases specimen analysis Sample collection for the purpose of Certified laboratory analysis to detect specific genetic variations associated with increased susceptibility for oral diseases such as severe periodontal disease. Yea 21 Accept X Motion to delete D0421 in lieu of revision and substitute a CDT Code addition (see Inventory # 16A). Nay 0 Decline Abstain 0 Other The approved action on D0421 is D0421 genetic test for susceptibility to oral diseases Sample collection for the purpose of certified laboratory analysis to detect specific genetic variations associated with increased susceptibility for oral diseases such as severe periodontal disease. The Code Maintenance Committee believes that the proposed revision substantially changes the nature of the procedure as described in the current CDT Code entry; the intended outcome is better addressed through deletion of the current entry and a CDT Code addition.

17 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 17 of 79 Inventory # 16A CID DIA-16a D0xxx Action Add CMC genetic test for susceptibility to diseases specimen analysis Certified laboratory analysis to detect specific genetic variations associated with increased susceptibility for diseases. Yea 19 Accept X Nay 2 Decline Abstain 0 Other

18 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 18 of 79 Inventory # 17. CID PRE-01 D1xxx Action Add AAPD comprehensive case management The collaborative process of overcoming barriers to accessing dental services and overall health care, accomplished through motivational interviewing, increasing health literacy, assisting in system navigation and tracking patient compliance or other related approaches necessary to achieving optimal oral health. The CMC addressed two descriptor amendments before the motion to accept PRE-01. 1) Replace the proposed descriptor with the following text The collaborative process which may include motivational interviewing, increasing health literacy, assisting in system navigation, or tracking patient compliance. Accept 9 Yea / 8 Nay / 4 Abstain 2) Revise the replacement descriptor text to read as follows The collaborative process of assisting in system navigation and tracking patient compliance, and may include motivational interviewing and increasing health literacy. Accept 14 Yea / 2 Nay / 5 Abstain Yea 7 Accept Motion to accept as amended Nay 13 Decline X Abstain 1 Other D1xxx comprehensive case management The collaborative process of assisting in system navigation and tracking patient compliance, and may include motivational interviewing and increasing health literacy. The Code Maintenance Committee declines this submission as the procedure remains ill-defined and lacks sufficient specificity to be understood.

19 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 19 of 79 Inventory # 18. CID PRE-02 D1xxx Action Add Dr. Abrams method/procedure for quantifying changes in structure of enamel, dentin, cementum for assessing performance of remineralization agents This code will be used to cover the time a clinician takes to use an instrument that is calibrated to quantify structural and mineral changes in tooth structure to assist in assessing the need for and efficacy of a remineralization / preventive regimen and/or agent. Yea 3 Accept Nay 17 Decline X Abstain 1 Other The Code Maintenance Committee considers the requested addition to be product-specific and addressing the time taken to use the device, with no specification of the dental procedure involved.

20 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 20 of 79 Inventory # 19. CID PRE-03 D1xxx Action Add Dr. Milgrom interim caries arresting medicament application Conservative treatment of an active, non-symptomatic carious lesion by topical application of a caries arresting or inhibiting medicament and without mechanical removal of sound tooth structure. The CMC addressed one descriptor amendment before the motion to accept PRE-03. Delete the final 8 words in the descriptor, as shown: Conservative treatment of an active, non-symptomatic carious lesion by topical application of a caries arresting or inhibiting medicament and without mechanical removal of sound tooth structure. Decline 2 Yea / 18 Nay / 1 Abstain Yea 19 Accept X Nay 2 Decline Accepted without amendment. Abstain 0 Other

21 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 21 of 79 Inventory # 20. CID RES-01 D2xxx Action Add Dr. Lewis resin-based composite incisal angle (anterior) None Yea 0 Accept Nay 21 Decline X Abstain 0 Other The Code Maintenance Committee found that the submission documentation did not establish a need for a new CDT Code entry, and the procedure as described is appropriately documented with the following existing CDT Code: D2335 resin-based composite four or more surfaces or involving incisal angle (anterior)

22 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 22 of 79 Inventory # 21. CID RES-02 D2xxx Action Add Dr. Dunham resin-based composite one surface posterior premolar Used to restore a carious lesion into the dentin or a deeply eroded area into the dentin of a premolar tooth. Not a preventative procedure. Yea 0 Accept The Code Maintenance Committee determined that the submission documentation does not establish the need for a new Nay 20 Decline X CDT Code entry. Tooth number identifies a premolar, and the procedure as described is appropriately documented with the following existing CDT Code: Abstain 1 Other D2391 resin-based composite one surface, posterior

23 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 23 of 79 Inventory # 22. CID RES-03 D2970 Action Delete CDBP temporary crown (fractured tooth) Usually a preformed artificial crown, which is fitted over a damaged tooth as an immediate protective device. This is not temporization during crown fabrication. Yea 15 Accept X Nay 5 Decline Abstain 1 Other

24 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 24 of 79 Inventory # 23. CID RES-04 Restorative, Implant Services, and Prosthodontic, fixed Action Revise Dr. DeCarli See Notes: below None Yea 0 Accept Nay 21 Decline X Abstain 0 Other The Code Maintenance Committee determined that the proposed wording change does not add clarity or improved understanding to the current CDT Code entries, and unnecessarily confuses selection of the appropriate code to document the delivered procedure. Notes: 1. The submitter appears to be requesting a nomenclature revision to all CDT Codes for single restoration crowns (D2720 D2794) and fixed partial denture retainer crowns (D6720 D6794), and their Implant equivalents. 2. An example of what appears to be the requested action follows: D2750 impression/prep for crown porcelain fused to high noble metal

25 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 25 of 79 Inventory # 24. CID RES-05 Restorative and Prosthodontic, fixed Action Add Dr. DeCarli crown and/or bridge-impression date Includes the date in which impression was taken for permanent crown/bridge. Yea 0 Accept Nay 21 Decline X Abstain 0 Other The Code Maintenance Committee determined that this request parses existing CDT Code entries, and does not bring clarity or other benefit to these restorative and fixed prosthodontic procedures.

26 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 26 of 79 Inventory # 25. CID RES-06 Restorative and Prosthodontic, fixed Action Add Dr. DeCarli crown and/or bridge-seat date Includes the date in which crown and/or bridge was cemented. Yea 0 Accept Nay 21 Decline X Abstain 0 Other The Code Maintenance Committee determined that this request parses existing CDT Code entries, and does not bring clarity or other benefit to these restorative and fixed prosthodontic procedures.

27 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 27 of 79 Inventory # 26. CID END-01 D3xxx Action Add Dr. Gamm cervical invasive resorption, surgical repair a new/revised code to allow for coverage for surgical repair of such defects. Yea 0 Accept The Code Maintenance Committee found that the submission documentation did not establish a need for a new CDT Nay 21 Decline X Code entry, and that the procedure as described is appropriately documented with existing surgical flap (D4241) and restorative codes (e.g., one-surface resin), or the following existing CDT Code: Abstain 0 Other D3427 periradicular surgery without apicoectomy

28 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 28 of 79 Inventory # 27. CID END-02 D3xxx Action Add Dr. Olsen add a fourth canal service for insurance reimbursement None Yea 0 Accept Nay 21 Decline X Abstain 0 Other The Code Maintenance Committee determined that the submission concerns a level of difficulty applicable to existing Endodontic Therapy CDT Code entries. A new CDT Code is not necessary because: a) the level of difficulty or complexity of dental procedures are expected to vary; and b) reporting by type of tooth vs. number of canals is well established.

29 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 29 of 79 Inventory # 28. CID PER-03 D4xxx Action Add Dr. Davis arch reformulation therapy The utilization of one or more removable appliances to improve the position and supporting structures of the dentition. Yea 0 Accept Nay 20 Decline X Abstain 1 Other The Code Maintenance Committee found that the submission documentation did not establish the need for a new CDT Code entry, and that the procedure as described is appropriately documented with existing orthodontic codes.

30 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 30 of 79 Inventory # 29. CID PER-01 D4xxx Action Add Dr. Charlin laser curettage, degranulation and decontamination for periodontal pocket reduction Non-surgical application of laser for curettage, degranulation and decontamination for periodontal pocket reduction in conjunction with periodontal prophylaxis or periodontal scaling. Yea 0 Accept Nay 21 Decline X Abstain 0 Other The Code Maintenance Committee determined that the submission addresses alternate instrumentation for procedures with existing CDT Code entries. A new CDT Code is not necessary because procedure delivery is independent of the dentist s armamentarium.

31 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 31 of 79 Inventory # 30. CID PER-13 D4xxx Action Add Dr. Kusek laser-assisted periodontal therapies (LAPT) This procedure involves thermal decontamination of diseased crevicular tissue to reduce periodontal pocket depths by means of lasers. It is indicated for patients with periodontal disease and is therapeutic, not prophylactic, in nature. This procedure may be used as a definitive treatment in certain stages of periodontal disease, as a part of pre-surgical procedures in others, and/or as a part of periodontal maintenance. Yea 0 Accept Nay 21 Decline X Abstain 0 Other The Code Maintenance Committee determined that the submission addresses alternate instrumentation for procedures with existing CDT Code entries. A new CDT Code is not necessary because procedure delivery is independent of the dentist s armamentarium.

32 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 32 of 79 Inventory # 31. CID PER-02 D4xxx Action Add Dr. Otterholt scaling in the presence of gingival disease This procedure is intended for patients with plaque-induced gingival diseases in the absence of clinical attachment loss. It includes removal of the bacterial plaque, calculus from supra-gingival and subgingival regions, stains, and polishing the teeth. It is therapeutic, not prophylactic, in nature. Yea 18 Accept Nay 2 Decline Abstain 1 Other X Motion to table Inventory #s definitely and refer to a CMC Ad-hoc Working Group for review and preparation of a recommendation for action during the 2016 CMC meeting.

33 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 33 of 79 Inventory # 32. CID PER-04a-c D4xxx Action Add Ms. Grill scaling and debridement light 4 or more teeth per quadrant scaling and debridement medium 4 or more teeth per quadrant scaling and debridement heavy 4 or more teeth per quadrant Light: The removal of supra and subgingival plaque, calculus, and stains, when there is more than 5 surfaces of readily detectable calculus in the quadrant. Medium: The removal of supra and subgingival plaque, calculus, and stains, when there is more than 10 surfaces of readily detectable calculus in the quadrant. Heavy: The removal of supra and subgingival plaque, calculus, and stains, when there is more than 20 surfaces of readily detectable calculus in the quadrant. Yea 18 Accept Nay 2 Decline Abstain 1 Other X Motion to table Inventory #s definitely and refer to a CMC Ad-hoc Working Group for review and preparation of a recommendation for action during the 2016 CMC meeting.

34 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 34 of 79 Inventory # 33. CID PER-11 D4xxx Action Add Ms. Raffi scaling performed in the presence of moderate to severe gingival inflammation Scaling performed in the presence of moderate to severe gingival inflammation with no clinical attachment loss (recession, bone loss, etc). Yea 18 Accept Nay 2 Decline Abstain 1 Other X Motion to table Inventory #s definitely and refer to a CMC Ad-hoc Working Group for review and preparation of a recommendation for action during the 2016 CMC meeting.

35 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 35 of 79 Inventory # 34. CID PER-12 D4355 Action Revise Ms. Raffi full mouth debridement to enable a comprehensive evaluation and diagnosis The gross removal of plaque and calculus that interfere with the ability of the dentist to perform a comprehensive oral evaluation. This preliminary procedure does not preclude the need for additional procedures. The purpose of Full Mouth Debridement is to enable a comprehensive evaluation and diagnosis. It involves the preliminary removal of supragingival plaque, calculus, and debris specifically to be following by appropriate definitive procedure(s) The CMC addressed two descriptor amendments before the motion to accept PER-12. 1) Change the proposed nomenclature and descriptor wording revisions as follows Accepted 20 Yea / 0 Nay / 1 Abstain: D4355 full mouth debridement to enable a comprehensive evaluation and diagnosis The purpose of Full Mouth Debridement is to enable a comprehensive evaluation and diagnosis. It involves the preliminary removal of supragingival plaque, and calculus, and debris specifically to be following by appropriate definitive that interfere with the ability of the dentist to perform a comprehensive oral evaluation. This procedure does not preclude the need for additional procedure(s). 2) Revise the changed descriptor to read as follows Declined 5 Yea / 16 Nay / 0 Abstain: The preliminary removal of plaque and calculus that interfere with the ability of the dentist to perform a comprehensive oral evaluation. This procedure is intended to lead to more definitive treatment does not preclude the need for additional procedures. Yea 5 Accept Nay 15 Decline X Abstain 1 Other The Code Maintenance Committee determined that the proposed wording changes, as submitted and amended, do not add clarity or improved understanding to the current CDT Code entry, and unnecessarily confuses selection of the appropriate code to document the delivered procedure.

36 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 36 of 79 Inventory # 35. CID PER-05 D4xxx Action Add AAP autogenous connective tissue graft procedure (including donor and recipient surgical sites) each additional contiguous tooth, implant or edentulous tooth position in same graft site Used in conjunction with D4273. Yea 17 Accept X Nay 3 Decline Abstain 1 Other

37 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 37 of 79 Inventory # 36. CID PER-06 D4xxx Action Add AAP non-autogenous connective tissue graft (including recipient surgical site and donor material) each additional contiguous tooth, implant, or edentulous tooth position in same graft site Used in conjunction with D4275. Yea 17 Accept X Nay 3 Decline Abstain 1 Other

38 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 38 of 79 Inventory # 37. CID PER-07 D4273 Action Revise AAP autogenous subepithelial connective tissue graft procedures (including donor and recipient surgical sites), per first tooth, implant, or edentulous tooth position in graft This procedure is performed to create or augment gingiva, to obtain root coverage to eliminate sensitivity and to prevent root caries, to eliminate frenum pull, to extend the vestibular fornix, to augment collapsed ridges, to provide an adequate gingival interface with a restoration or to cover bone or ridge regeneration sites when adequate gingival tissues are not available for effective closure. There are two surgical sites. The recipient site utilizes a split thickness incision, retaining the overlying overlapping flap of gingiva and/ or mucosa. The connective tissue is dissected from a separate the donor site leaving an epithelialized flap for closure. After the graft is placed on the recipient site, it is covered with the retained overlying flap. Yea 15 Accept X Nay 4 Decline Yea/Nay/Abstain vote total is 20 vs. 21 as one CMC member organization was not present at the time of ballot. Abstain 1 Other

39 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 39 of 79 Inventory # 38. CID PER-08 D4275 Action Revise AAP non-autogenous connective soft tissue allograft (including recipient site and donor material) first tooth, implant, or edentulous tooth position in graft Procedure is performed to create or augment the gingiva, with or without root coverage. This may be used to eliminate the pull of the frena and muscle attachments, to extend the vestibular fornix, and correct localized gingival recession. There is no donor site. only a recipient surgical site utilizing split thickness incision, retaining the overlaying flap of gingiva and/or mucosa. A donor surgical site is not present. Yea 17 Accept X Nay 4 Decline Abstain 0 Other

40 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 40 of 79 Inventory # 39. CID PER-09 D4277 Action Revise AAP free soft tissue graft procedure (including recipient and donor surgical sites surgery) first tooth, implant, or edentulous tooth position in graft None Yea 17 Accept X Nay 3 Decline Abstain 1 Other

41 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 41 of 79 Inventory # 40. CID PER-10 D4278 Action Revise AAP free soft tissue graft procedure (including recipient and donor surgery surgical sites) each additional contiguous tooth, implant, or edentulous tooth position in same graft site Used in conjunction with D4277. Yea 17 Accept X Nay 3 Decline Abstain 1 Other

42 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 42 of 79 Inventory # 41. CID PRR-01 Prosthodontics, removable & Implant Services Action Add Dr. Lizzack change the housing for male or female component of semi or precision attachment change the housing for male or female component of semi- precision or precision attachment of an implant supported prosthesis per housing. Often the housing fails to hold the nylon component and the housing itself needs replacing. Yea 0 Accept The Code Maintenance Committee found that the submission documentation did not establish the need for a new CDT Code entry, and that the procedure as described is appropriately documented with the following existing CDT Codes: Nay 21 Decline X D5867 replacement of replaceable part of semi-precision or precision attachment (male or female component) Abstain 0 Other D6091 replacement of replaceable part of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis, per attachment This procedure applies to the replaceable male or female component of the attachment.

43 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 43 of 79 Inventory # 42. CID PRR-02 D5xxx Action Add Dr. Matthews immediate maxillary partial denture resin base (including any conventional clasps, rests and teeth) Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a new partial denture. The CMC addressed one descriptor amendment before the motion to accept PRR-02. Change the proposed descriptor wording revisions as follows Accepted 11 Yea / 10 Nay / 0 Abstain: Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a new partial denture. Yea 20 Accept X Nay 1 Decline Abstain 0 Other Motion to accept as amended D5xxx immediate maxillary partial denture resin base (including any conventional clasps, rests and teeth) Includes limited follow-up care only; does not include future rebasing / relining procedure(s).

44 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 44 of 79 Inventory # 43. CID PRR-03 D5xxx Action Add Dr. Matthews immediate mandibular partial denture resin base (including any conventional clasps, rests and teeth) Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a new partial denture. The CMC addressed one descriptor amendment before the motion to accept PRR-03. Change the proposed descriptor wording revisions as follows Accepted 18 Yea / 3 Nay / 0 Abstain: Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a new partial denture. Yea 20 Accept X Nay 1 Decline Abstain 0 Other Motion to accept as amended D5xxx immediate mandibular partial denture resin base (including any conventional clasps, rests and teeth) Includes limited follow-up care only; does not include future rebasing / relining procedure(s).

45 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 45 of 79 Inventory # 44. CID PRR-04 D5xxx Action Add Dr. Matthews immediate maxillary partial denture cast metal framework with resin denture bases (including any conventional clasps, rests and teeth) Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a new partial denture. The initial CMC vote to accept this request failed (4 Yea / 16 Nay / 1 Abstain) with the rationale There is no evidence that the frequency of this procedure s delivery is sufficient to justify a unique CDT Code; it may be reported by D5899. A motion to reconsider was accepted (20 Yea / 1 Nay / 0 Abstain) that enabled amending the descriptor before a vote to accept as amended. The CMC proposed and accepted (18 Yea / 3 Nay / 0 Abstain) the following descriptor revision. Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a new partial denture. Yea 18 Accept X Motion to accept as amended during reconsideration Nay 2 Decline Abstain 1 Other D5xxx immediate maxillary partial denture cast metal framework with resin denture bases (including any conventional clasps, rests and teeth) Includes limited follow-up care only; does not include future rebasing / relining procedure(s).

46 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 46 of 79 Inventory # 45. CID PRR-05 D5xxx Action Add Dr. Matthews immediate mandibular partial denture cast metal framework with resin denture bases (including any conventional clasps, rests and teeth) Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a new partial denture. The CMC addressed one descriptor amendment before the motion to accept PRR-05. Change the proposed descriptor wording revisions as follows Accepted 19 Yea / 2 Nay / 0 Abstain: Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a new partial denture. Yea 17 Accept X Motion to accept as amended Nay 4 Decline Abstain 0 Other D5xxx immediate mandibular partial denture cast metal framework with resin denture bases (including any conventional clasps, rests and teeth) Includes limited follow-up care only; does not include future rebasing / relining procedure(s).

47 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 47 of 79 Inventory # 45a CID PRR-10a D5130 Action Revise CMC immediate denture maxillary Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a complete new denture. Yea 18 Accept X Nay 1 Decline Abstain 2 Other The Code Maintenance Committee introduced this revision during the 2015 meeting to achieve consistency with this current CDT Code entry and the immediate partial additions (Inventory #s / PRR-02 PRR-05) listed above.

48 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 48 of 79 Inventory # 45b CID PRR-10b D5140 Action Revise CMC immediate denture mandibular Includes limited follow-up care only; does not include future rebasing / relining procedure(s) or a complete new denture. Yea 18 Accept X Nay 1 Decline Abstain 2 Other The Code Maintenance Committee introduced this revision during the 2015 meeting to achieve consistency with this current CDT Code entry and the immediate partial additions (Inventory #s / PRR-02 PRR-05) listed above.

49 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 49 of 79 Inventory # 46. CID PRR-06 D5875 Action Revise CDBP modification of removable prosthesis following implant surgery Attachment assemblies are reported using separate codes. The modification of existing removable prosthesis is sometimes necessary at the time of implant placement and bone graft surgery and is always necessary at the time of the placement of the healing caps. This code could also be used for the modification of an existing prosthesis when the abutments are placed and retentive elements are placed into the removable prosthesis, thereby reducing the need for a new prosthesis. Yea 18 Accept X Nay 2 Decline Abstain 1 Other

50 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 50 of 79 Inventory # 47. CID PRR-07 D5xxx Action Add CDBP semi-precision attachment placement of keeper assembly into removable prosthesis Procedure can accommodate placement on a mini-implant, implant, or natural tooth. Not to be used when replacing worn retentive components. Yea 0 Accept Nay 0 Decline Withdrawn by submitter. Abstain 0 Other X

51 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 51 of 79 Inventory # 48. CID PRR-08 D5630 Action Revise NADP repair or replace broken clasp per tooth None Yea 20 Accept X Nay 1 Decline Abstain 0 Other

52 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 52 of 79 Inventory # 49. CID PRR-09 D5660 Action Revise NADP add clasp to existing partial denture per tooth None Yea 21 Accept X Nay 0 Decline Abstain 0 Other

53 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 53 of 79 Inventory # 50. CID IMP-01 D6053 Action Revise Dr. Daniels implant/abutment supported retained removable denture for completely edentulous arch None Yea 4 Accept Nay 15 Decline X Abstain 2 Other D6053 no longer exists, being replaced by D6110 and D6111 in CDT CMC discussion noted that the requested revision could also be applicable to several other CDT Code entries with the word supported in their nomenclatures. The committee s conclusion is that all CDT Code entries with the term supported should be reviewed and addressed together.

54 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 54 of 79 Inventory # 51. CID IMP-02 D6xxx Action Add NADP implant pontic - cast high noble metal implant pontic - cast predominantly base metal implant pontic - cast noble metal implant pontic - titanium implant pontic - porcelain fused to high noble metal implant pontic - porcelain fused to predominantly base metal implant pontic - porcelain fused to noble metal implant pontic porcelain/ceramic None Yea 2 Accept Nay 17 Decline X Abstain 2 Other The Code Maintenance Committee found that the submission documentation did not establish a need for a new set of CDT Code entries. Pontic procedure codes in the Prosthodontics, fixed category of service have sufficed to appropriately document their use in Implant cases.

55 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 55 of 79 Inventory # 52. CID OMS-01 D7xxx Action Add NADP occlusal orthotic device adjustment None Yea 20 Accept X Nay 1 Decline Abstain 0 Other

56 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 56 of 79 Inventory # 53. CID ORT-01 D8xxx Action Add Ms. Pratt orthodontic treatment in progress Orthodontic treatment claim code for when orthodontic coverage begins after treatment has started. Yea 0 Accept Nay 20 Decline X Abstain 1 Other The Code Maintenance Committee found that the submission documentation did not establish a need for a new CDT Code entry, and that the procedure as described is appropriately documented with existing CDT Code: D8670 periodic orthodontic treatment visit

57 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 57 of 79 Inventory # 54. CID ORT-02 D8xxx Action Add NADP removable orthodontic retainer adjustment None Yea 21 Accept X Nay 0 Decline Abstain 0 Other

58 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 58 of 79 Inventory # 55. CID ADJ-01 D9xxx Action Add Dr. McDevitt oral conscious sedation additional hour Oral sedation for longer procedures that require multiple hours of chair time to complete treatment on a high feat (sic) patient. Yea Nay 0 20 Accept Decline X The Code Maintenance Committee found that the submission for a additional hour procedure presents a paradox as there is no CDT Code for the first hour procedure. Further, the procedure described in the submission is appropriately documented with CDT 2015 Code entry D9248 non-intravenous moderate (conscious) sedation and Abstain 1 Other D9248 as revised for CDT 2016 (Inventory # 60a CID ADJ-19) which states that the procedure is applicable to both minimal and moderate sedation.

59 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 59 of 79 Inventory # 56. CID ADJ-02 D9xxx Action Add Dr. Smith non-iv moderate conscious sedation each additional hour A medically controlled state of depressed consciousness while maintaining the patient's airway, protective reflexes and the ability to respond to stimulation or verbal commands. It includes non-iv administration of sedative and / or analgesic agent(s) and appropriate monitoring for each additional hour. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients or duties. The level of anesthesia is determined by the anesthesia provider's documentation of the anesthetic effect upon the central nervous system and not dependent upon the route of administration. Yea Nay 0 21 Accept Decline X The Code Maintenance Committee found that the submission for a additional hour procedure presents a paradox as there is no CDT Code for the first hour procedure. Further, the procedure described in the submission is appropriately documented with CDT 2015 Code entry D9248 non-intravenous moderate (conscious) sedation and Abstain 0 Other D9248 as revised for CDT 2016 (Inventory # 60a CID ADJ-19) which states that the procedure is applicable to both minimal and moderate sedation.

60 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 60 of 79 Inventory # 57. CID ADJ-03a D9248 Action Revise Dr. Rafoth oral conscious sedation additional hour Oral Sedation for longer procedures that require multiple hours of chair time to complete treatment on a high fear patient. Yea Nay 0 21 Accept Decline X The Code Maintenance Committee found that the submission for a additional hour procedure presents a paradox as there is no CDT Code for the first hour procedure. Further, the procedure described in the submission is appropriately documented with CDT 2015 Code entry D9248 non-intravenous moderate (conscious) sedation and Abstain 0 Other D9248 as revised for CDT 2016 (Inventory # 60a CID ADJ-19) which states that the procedure is applicable to both minimal and moderate sedation.

61 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 61 of 79 Inventory # 58. CID ADJ-03b D9xxx Action Add Dr. Rafoth non-intravenous conscious sedation each additional hour OR oral conscious sedation additional hour Oral sedation for longer procedures that require multiple hours of chair time to complete treatment on a high fear patient. Yea Nay 0 21 Accept Decline X The Code Maintenance Committee found that the submission for a additional hour procedure presents a paradox as there is no CDT Code for the first hour procedure. Further, the procedure described in the submission is appropriately documented with CDT 2015 Code entry D9248 non-intravenous moderate (conscious) sedation and Abstain 0 Other D9248 as revised for CDT 2016 (Inventory # 60a CID ADJ-19) which states that the procedure is applicable to both minimal and moderate sedation.

62 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 62 of 79 Inventory # 59. CID ADJ-04 D9xxx Action Add Dr. Galluzzo diagnostic images transmission None Yea 1 Accept Nay 20 Decline X Abstain 0 Other The Code Maintenance Committee found that the submission documentation did not establish a need for a new CDT Code entry; as described the activity is not a procedure.

63 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 63 of 79 Inventory # 60. CID ADJ-05 D9xxx Action Add CDBP mild (minimal) sedation anxiolysis Use of a pharmacological method to induce relief of patient apprehension with minimal effect on sensorium. Yea Accept Nay Decline Abstain Other X Rendered moot. The Code Maintenance Committee accepted its own D9248 revision (Inventory # 60a / CID ADJ-19), following immediately below, which states that the procedure is applicable to both minimal and moderate sedation.

64 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 64 of 79 Inventory # 60a CID ADJ-19 D9248 Action Revise CMC non-intravenous moderate (conscious) sedation This includes non-iv minimal and moderate sedation. A medically controlled state of depressed consciousness while maintaining the patient s airway, protective reflexes and the ability to respond to stimulation or verbal commands. It includes non-intravenous administration of sedative and/or analgesic agent(s) and appropriate monitoring. The level of anesthesia is determined by the anesthesia provider s documentation of the anesthetic s effects upon the central nervous system and not dependent on the route of administration. Yea 11 Accept X Nay 7 Decline Abstain 3 Other

65 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 65 of 79 Inventory # 61. CID ADJ-06 D9xxx Action Add NADP deep sedation/general anesthesia each 15 minute increment Anesthesia time begins when the doctor administering the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains in continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients or duties. The level of anesthesia is determined by the anesthesia provider s documentation of the anesthetics effects upon the central nervous system and not dependent upon the route of administration. Yea 12 Accept X Nay 9 Decline Abstain 0 Other A motion to reconsider failed 3 Yea / 18 Nay / 0 Abstain

66 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 66 of 79 Inventory # 62. CID ADJ-15 D9xxx Action Add Dr. Teague office-based general anesthesia/deep sedation first 30 minutes; no other services provided except deep sedation/general anesthesia Anesthesia services begin when the doctor places appropriate equipment for induction and monitoring and remains in the presence of the patient for induction and maintenance of anesthesia. Anesthesia time continues while the patient recovers and the doctor continues to be in the presence of the patient or remains readily available. Anesthesia time ends when the patient meets criteria for discharge to leave the office. Yea 1 Accept Nay 20 Decline X Abstain 0 Other The Code Maintenance Committee found that the submission documentation did not establish a need for a new CDT Code entry, and the procedure as described is appropriately documented with CDT 2015 Code entry D9220 deep sedation/general anesthesia first 30 minutes and its CDT 2016 replacement D9xxx deep sedation/general anesthesia each 15 minute increment (Inventory # 61 CID ADJ-06).

67 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 67 of 79 Inventory # 63. CID ADJ-16 D9xxx Action Add Dr. Teague office-based general anesthesia/deep sedation each additional 15 minutes; no other services provided except deep sedation/general anesthesia Anesthesia services begin when the doctor places appropriate equipment for induction and monitoring and remains in the presence of the patient for induction and maintenance of anesthesia. Anesthesia time continues while the patient recovers and the doctor continues to be in the presence of the patient or remains readily available. Anesthesia time ends when the patient meets criteria for discharge to leave the office. Yea 1 Accept Nay 19 Decline X Abstain 1 Other The Code Maintenance Committee found that the submission documentation did not establish a need for a new CDT Code entry, and the procedure as described is appropriately documented with CDT 2015 Code entry D9221 deep sedation/general anesthesia each additional 15 minutes and its CDT 2016 replacement D9xxx deep sedation/general anesthesia each 15 minute increment (Inventory # 61 CID ADJ-06).

68 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 68 of 79 Inventory # 64. CID ADJ-07 D9xxx Action Add NADP intravenous moderate (conscious) sedation/analgesia each 15 minute increment Anesthesia time begins when the doctor administering the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains in continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients or duties. The level of anesthesia is determined by the anesthesia provider s documentation of the anesthetics effects upon the central nervous system and not dependent upon the route of administration. Yea 17 Accept X Nay 3 Decline Abstain 1 Other

69 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 69 of 79 Inventory # 65. CID ADJ-08 D9220 Action Delete NADP deep sedation/general anesthesia first 30 minutes Anesthesia time begins when the doctor administering the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains in continuous attendance of the patient. Anesthesia services are considered completed when the patient mae be safely left under the observation of trained personnel and the doctor may safgely leave the room to attend to other patients or duties. The level of anesthesia is determined by the anesthesia provider s documentation of the anesthetics effects upon the central nervous system and not dependent upon the route of administration. Yea Accept X Nay Abstain Decline Other Accepted by acclamation due to the Code Maintenance Committee s acceptance of Inventory # 61 CID ADJ-06 above.

70 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 70 of 79 Inventory # 66. CID ADJ-09 D9221 Action Delete NADP deep sedation/general anesthesia each additional 15 minutes None Yea Accept X Nay Abstain Decline Other Accepted by acclamation due to the Code Maintenance Committee s acceptance of Inventory # 61 CID ADJ-06 above.

71 Code Maintenance Committee Substantive Action Report Submissions for CDT 2016 Page 71 of 79 Inventory # 67. CID ADJ-10 D9241 Action Delete NADP intravenous moderate (conscious) sedation/analgesia first 30 minutes Anesthesia time begins when the doctor administering the anesthetic agent initiates the appropriate anesthesia and non-invasive monitoring protocol and remains in continuous attendance of the patient. Anesthesia services are considered completed when the patient may be safely left under the observation of trained personnel and the doctor may safely leave the room to attend to other patients or duties. The level of anesthesia is determined by the anesthesia provider s documentation of the anesthetics effects upon the central nervous system and not dependent upon the route of administration. Yea Accept X Nay Abstain Decline Other Accepted by acclamation due to the Code Maintenance Committee s acceptance of Inventory # 64 CID ADJ-07 above.