Council broadens definition in CDT Code

June 13, 2012
New nomenclature applies to all porcelain/ceramic CDT codes, including D2740 for crowns and codes for inlays/onlays.

ST. PAUL, Minnesota--In response to requests from 3M ESPE and the dental community, the ADA will broaden the definition of porcelain/ceramic materials in its CDT Code for insurance reimbursement to allow 3M ESPE Lava Ultimate Restorative to be classified as a porcelain/ceramic.

The change will be effective Jan. 1, 2013, making it possible for dentists who use the material to file for insurance reimbursement. This includes using CDT code D2740 for crowns.

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Lava Ultimate restorative is a new material formulated from a blend of approximately 80% nanoceramic particles embedded in a highly cured resin matrix by using a proprietary 3M manufacturing process. The material is available for chairside milling using CEREC or E4D systems or can be ordered as a finished restoration from Authorized Lava Milling Centers, Jensen Milling Centers, and Straumann CARES Digital Solutions.

At the time the material was launched, the ADA’s CDT Code nomenclature did not yet reflect the advances in material science that Lava Ultimate restorative represents. This resulted in challenges with selecting the proper CDT code for insurance reimbursement.

But following a formal request from 3M ESPE, the ADA has broadened the material definition of indirect porcelain/ceramic restorations. With this change, Lava Ultimate restorative will fall under any CDT code defined for ceramics, allowing for the same rate of reimbursement as other ceramic materials.

The new CDT Code definition reads:

Refers to the pressed, fired, polished or milled materials containing predominantly inorganic refractory compounds — including porcelains, glasses, ceramics and glass-ceramics.

"By broadening the definition of porcelain/ceramics in the CDT Code, the ADA's Council on Dental Benefits is making the benefits of advanced material science accessible to more patients,” said John Stefanick, director of industry and professional relations, 3M ESPE.

“This CDT Code change will be welcomed by many dentists.”

The streamlined insurance reimbursement enabled by the revised definition of glass ceramics in the nomenclature of the CDT Code will make it easier for dentists to take advantage of Lava Ultimate restorative’s functionality to provide restorations that are strong as well as kind to opposing dentition.

The restorations can be repaired intraorally if necessary, and are backed by a 10-year warranty from 3M ESPE. With the ability to code Lava Ultimate restorative like other porcelain/ceramic materials for insurance reimbursement, more dentists and patients will be able to experience the qualities of the material.

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