Is D9991 covered by insurance?

Coverage for D9991 varies by insurance provider. It's important to verify with the patient's insurance to determine if this code is covered.

How often can D9991 be billed?

There are no specific frequency limitations for D9991, but each use must be justified with proper documentation of the barriers addressed.

What should be documented when using D9991?

Document the specific barriers, the efforts made to address them, and the patient's response or improvement in appointment adherence.

Can D9991 be used in conjunction with clinical procedures?

Yes, D9991 can be used alongside clinical procedures, but it should be billed separately as it addresses non-clinical barriers.

D9991

Appointment Compliance Barriers - CDT Code Guide

Adjunctive General Services/Non-clinical procedures

Overview

CDT code D9991 is designed to help dental professionals manage and overcome barriers that prevent patients from maintaining their scheduled appointments. This code is part of the Adjunctive General Services category and focuses on non-clinical procedures. It involves individualized efforts to address issues such as transportation challenges or other obstacles that hinder a patient's ability to attend dental appointments. By using this code, dental practices can document and bill for the time and resources spent on ensuring patients can adhere to their treatment schedules, ultimately improving patient outcomes and practice efficiency.

When to Use This Code

When a patient frequently misses appointments due to lack of transportation.
To assist a patient with mobility issues in arranging accessible transportation.
For patients who face language barriers that affect their ability to schedule and attend appointments.
When a patient requires reminders or follow-up calls to ensure appointment adherence.
To address socioeconomic factors that prevent a patient from attending scheduled visits.

Documentation Requirements

Document the specific barrier preventing appointment compliance.
Record the individualized efforts made to assist the patient.
Include any communication with transportation services or third-party assistance.
Note the patient's response and any changes in appointment adherence.
Maintain records of any follow-up actions taken to ensure compliance.

Billing Considerations

When billing for D9991, it's important to note that this code is typically used for non-clinical services and may not be covered by all insurance plans. Practices should verify coverage with the patient's insurance provider. There are no specific frequency limitations, but documentation should clearly justify the need for repeated use. Common modifiers may not apply, but it's crucial to ensure accurate and thorough documentation to support billing.

Related CDT Codes

D9992 D9993 D9994 D9995

Frequently Asked Questions

D9991 should be used specifically for patients who face significant barriers to attending appointments, such as transportation issues or language barriers.

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