2025 Coding and Payment Guide for Dental Services (Spiral)
Optum | 2025 |
The Coding and Payment Guide for Dental Services is your one-stop coding, reimbursement, and documentation resource developed exclusively for dental practices. This comprehensive and easy-to-use guide is updated for 2025 and organized by specialty-specific CDT and CPT® codes. Each code includes its official description and lay description, coding tip, documentation and reimbursement tips, Medicare edits, RVUs and is cross-coded to common ICD-10-CM diagnosis codes to complete the coding process. Getting to the code information you need has never been so easy.
- Quickly find information. All the information you need is provided, including CDT and CPT® full code descriptions, lay descriptions, coding tips, procedure code-specific documentation and reimbursement tips, and commonly associated ICD-10-CM diagnosis codes.
- Procedure code icons – Quickly identify new, revised, add-on, and telemedicine procedure codes, making your coding process for procedures quick and efficient.
- ICD-10-CM code icons – Icons identify age-related and laterality diagnosis codes.
- Evaluation and Management (E/M) Services Guidelines – With CPT® E/M Guidelines and our Optum Coding Tips, you have all the information you need to select the correct E/M code for the service provided.
- Prevent claim denials and stay up-to-date with Medicare payer information. Review Medicare IOM references containing information linked to CDT, HCPCS Level II, and CPT® codes tailored to dental services, to prepare cleaner claims before submission.
- Easily determine fees for your practice and reinforce consistency in the charges. Relative value units including the practice, work, and malpractice components with total RVUs for non-facility and facility services are included.
- CCI edits. CCI edits for CDT, CPT® and HCPCS procedure codes are included in a special section with quarterly updates available online at Optumcoding.com Product Update page.
- Helpful illustrations. Detailed illustrations provide a better understanding of the anatomy related to dental procedures and services.
CPT® is a registered trademark of the American Medical Association.
CDT© 2023 American Dental Association
CDT© 2023 American Dental Association
Nannette Orme, CCS-P
Ms. Orme has more than 30 years of experience in the healthcare profession. She has extensive background in CPT/HCPCS and ICD-9-CM coding and has completed comprehensive ICD-10-CM and PCS training. Her prior experience includes physician clinics and healthcare consulting. Her areas of expertise include physician audits and education, compliance and HIPAA legislation, litigation support for Medicare self-disclosure cases, hospital chargemaster maintenance, workers' compensation, and emergency department coding. Ms. Orme has presented at national professional conferences, contributed articles for several professional publications, and served on the advisory board of a local college. She is a member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).
Jaqueline Petersen, MHA, RHIA, CHDA, CPC
Ms. Petersen is a subject matter expert (SME) with Optum360. She has served as Senior Clinical Product Research Analyst with Optum360 developing business requirements for edits to support correct coding and reimbursement for claims processing applications. Her experience includes development of data-driven and system rules for both professional and facility claims and in-depth analysis of claims data inclusive of ICD-10-CM, CPT®, HCPCS and modifiers. Her background also includes consulting work for Optum, serving as a SME, and providing coding and reimbursement education to internal and external clients. Ms. Petersen is a member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).
CPT is a registered trademark of the American Medical Association.
CPT is a registered trademark of the American Medical Association.
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