Coding with Kyle: Saliva testing with new ADA code D0418

Feb. 11, 2020

There are two new saliva codes: one for analyzing a saliva sample, and one for the assessment of salivary flow by measurement.

Kyle L. Summerford

Code D0418 is for the analysis of a saliva sample.

The purpose of this code is for the chemical or biological analysis of a saliva sample for diagnostic purposes.

Code D0419 is the assessment of salivary flow by measurement.

The purpose of this code is for the identification of low salivary flow in patients who are at risk for hyposalivation and xerostomia, as well as for effectiveness of pharmacological agents used to stimulate saliva production.

Xerostomia—The patient’s oral cavity may constantly feel dry.

Hyposalivation—The patient may have a decrease in salivary function.

These conditions can contribute to increases in the risk for dental diseases.

When filing an insurance claim with the patient’s dental insurance, the following information should be provided.

Describe what form of testing has been used to diagnose the patient. Here are a few common diagnostic testing devices:

MyPerioPath by Oral DNA Labs
Dentocult SM Strip Mutans by Orion Diagnostica
CRT Bacteria by Ivoclar
Saliva-Check buffer by GC America

Submit a clear written narrative that explains the benefits of the testing device and outlines the treatment plan with the desired prognosis that will help explain the need for treatment.

It is too early to know if insurance companies will adopt a standard protocol for processing and paying claims for preventive testing of salivary diagnostics.

It is strongly recommended that your office obtain a breakdown of benefits from the patient’s dental plan in order to determine coverage.

Kyle L. Summerford is a nationally recognized practice management guru, author, and lecturer. He is founder and president of Summerford Solutions Inc., and cofounder of Elitedentalclaims.com. Kyle also serves as editorial director of Dental Office Manager Digest e-newsletter. He lectures extensively to dentists and their staff on topics such as insurance coding and billing and useful practice management tips. Contact him at [email protected].

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About the Author

Kyle L. Summerford

With more than 22 years of experience in dental, Kyle L. Summerford has a unique approach to case presentation and patient acceptance. As an OM and financial dental consultant, he leverages his knowledge to assist new and struggling dental practices. Through his education programs, Kyle empowers staff members with effective patient education skills and persuasion techniques. He has lectured at CE events and academic institutions. His expertise is further recognized through his column, Dental Coding with Kyle. He’s the founder of the Dental Office Managers Community. Visit his website at kylesummerford.com.