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MedicaidBilling CodesMedium impact

2019 Dental Fee Schedule Clarifications and HIPAA Compliance Update pdf

Connecticut Medicaid (HUSKY Health)·CT · Dentistry, Oral & Maxillofacial Surgery·Reimbursement
Effective date
Jan 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Connecticut Medicaid updated their dental fee schedule with new CDT and CPT codes for space maintainers, occlusal guards, and various oral surgery procedures. Key changes include deletion of old bilateral space maintainer codes, addition of more specific replacement codes, and new coverage for EXPAREL® pain management.

Action Required

Action needed
Effective January 1, 2019: Billing team must update billing system to replace deleted bilateral space maintainer codes D1515, D1525, and D9940 with new specific codes D1516-D1517 (fixed) and D1526-D1527 (removable). Add new CDT and CPT codes D0412, D9610, D9613, and multiple 20000-64000 series surgical codes with proper fee schedules. For D9610 submissions, include medication type and cost for manual pricing. For D9613 EXPAREL® claims, add 'EXPAREL®' in remarks section for third-molar or full mouth extractions. Restrict D2390 to primary teeth C,D,E,F,G,L,M,N,O,P,Q only.

Affected Billing Codes

D1515
D1516
D1517
D1525
D1526
D1527
D9940
D9944
D9945
D0412
D9610
D9613
20220
20225
20240
20245
21010
21011
21012
21013
21014
21015
21016
21026
21029
21030
21031
21032
21034
21045
21046
21047
21048
21049
21050
21070
21073
21076
21077
21079
21080
21081
21082
21083
21084
21085
21086
21087
21089
21100
21110
21116
21125
21127
21137
21138
21139
21209
21235
21240
21242
21243
21282
21295
21296
21299
21336
21344
21348
21499
21501
21502
21510
21550
21552
21554
21555
21556
21557
21558
21600
21610
21615
21616
21620
21627
21700
21705
21720
21725
64716
64910
D2390