This year’s CDT update includes some major changes, and if you are not prepared for them, you could be leaving money on the table. The 2026 update includes 31 new high-specificity codes, as well as 14 revisions and 6 deletions. While these changes are intended to make things clearer, they might add to your confusion for a while as you get the hang of them. Well, if you’re having a tough time trying to keep these new codes straight, talk to a trusted name in the field about ways to stay compliant.
Our office at Dental Auditing Solutions is built to help you know more. We make it our business to know these things, and we’ve been paying close attention to CDT changed this year, particularly in the realm of diagnostics, sedation, and restoration. We’re also here to help you retire old codes like D6095 and COVID-19 vaccination codes that just don’t apply anymore. Our teams wants yours to send in thorough, complete claims with the right codes, so let’s talk to find out where you’re slipping up.
The old way of coding is a great way to be denied. Learn more about CDT code changes for 2026 with Dental Auditing Solutions.
Diagnostic Codes Are Becoming More Specific
Traditionally, dentists billed for their time diagnosing a cracked tooth through their limited standard exam (D0140). But this year, the CDT introduces a new one, specifically focused on testing for a cracked tooth, since this is a detailed process including a range of diagnostic tests. Transillumination and bite tests take up your time, and you want to be paid for it. This new code, D0461, helps you do that.
With D0461, providers can document specific diagnostic examination findings. That is not only helpful for you as a provider, but it also helps payers to know your processes. As usual, be precise and thorough with your clinical notes so you can justify using the code.
Learning High-Specificity Anesthesia/Sedation Codes
If your office offers sedation, or if you require anesthesia for surgical procedures, then there are some things you definitely need to know this year. Firstly, D9248, the generic code for “non-intravenous conscious sedation” is no longer in effect, as payers want to see high-specificity documentation.
This is a change that requires immediate attention. If your office continues to use the discontinued D9248 code, you’re bound to see a denial immediately. Ensure that your workplace software has been updated to reflect the change. Also, Nitrous is not billable if you give and bill other sedation.
Audit Trends
If you do not have an internal auditing program or are periodically using a third party to audit claims, I highly suggest you start. With multiple stories of Medicare and Medicaid Fraud and the fact that CMS which partially funds state Medicaid programs, audits from state Medicaid OIG and managed care payers will be on the rise. We can help you with periodic claim reviews, call us for more information.
Code Questions? Call Dental Auditing Solutions
There are quite a few changes in this year’s CDT update. If you’re struggling to figure them out, call Dental Auditing Solutions at (972) 459-1508 today.