HCPCS D2141 is referenced in 2 tracked payer policy changes from EmblemHealth. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS D2141 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
EmblemHealth is changing the frequency limit for dental fillings (D2140-D2430) from once every 6 months to once every 12 months on the same tooth by the same provider, effective January 1, 2027. This change also applies to inlays, onlays, veneers, crowns, or crown retainers performed after fillings on the same tooth within the last 12 months.
EmblemHealth is changing frequency limitations for dental procedures: fillings (D2140-D2430) will be limited to once every 12 months per tooth instead of every 6 months, and closure of oroantral fistula/sinus perforation (D7260-D7261) will be limited to once every 12 months per quadrant. The original March 7, 2025 effective date has been postponed with no new date announced yet.
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