2025 Code and Processing Changes
The following list outlines new codes, deleted codes, and processing policy revisions that will take effect
January 1, 2025.
There are ten (10) new codes, two (2) deleted codes and three (3) processing policy revisions. Many of the new codes further define existing procedures.
Please be sure not to submit claims for the new codes with dates of service prior to January 1, 2025, and do not submit claims for the deleted codes for dates of service on or after January 1, 2025. Your claims will be returned to your office for resubmission with the correct codes for the dates of service involved, which results in unnecessarily delaying the processing of your claims.
New Codes for 2025
- D2956: Removal of an indirect restoration on a natural tooth
The removal of an indirect restoration is included in the definitive treatment and the fees are NOT BILLABLE TO THE PATIENT. - D6180: Implant maintenance procedures when a full arch fixed hybrid prosthesis is not removed, including cleansing of prosthesis and abutments
Benefits for D6180 are DENIED unless covered by group/individual contract.
If implant services and D6114 and D6115 are covered, benefits are limited to once every 12 months. Benefits for D6080 and D6180 are DENIED if done more frequently.
Fees for D6180 are not billable to the patient if done within 12 months of D6114 and D6115. - D6193: Replacement of an implant screw
Benefits are DENIED unless implants are covered by group/individual contract.
When covered: Fees for replacement of an implant screw, if performed within six months of the initial placement of the prosthesis, by the same dentist/dental office, are NOT BILLABLE TO THE PATIENT.
Benefits are limited to once per implant every 24 months.
Fees for D6089 are NOT BILLABLE TO THE PATIENT on the same date of services as D6193. - D7252: partial extraction for immediate implant placement
Benefits are DENIED unless covered by group/individual contract.
If implant services are covered: Benefits are limited to once per tooth, in conjunction with immediate implant placement. - D7259: nerve dissection
Benefits for nerve dissection are DENIED as a specialized procedure.
Nerve dissection is part of D7241 and the fees are NOT BILLABLE TO THE PATIENT when done on the same date of service. - D8091: comprehensive orthodontic treatment with orthognathic surgery
Benefits are DENIED when the supporting documentation does not meet the criteria for coverage.
Fees for limited orthodontic treatment (D8010-D8040) and comprehensive orthodontic treatment (D8070-D8090) when submitted on the same date of service as D8091 are NOT BILLABLE TO PATIENT. - D8671: periodic orthodontic treatment visit associated with orthognathic surgery
Fees for D8671 are NOT BILLABLE to the PATIENT when done on the same date of service as D8091. - D9913: administration of neuromodulators
Benefits for D9913 are DENIED unless covered by group/individual contract. - D9914: administration of dermal fillers
Benefits for D9914 are DENIED unless covered by group/individual contract. - D9959: unspecified sleep apnea services procedure, by report
Benefits for D9959 are DENIED unless covered by group/individual contract.
Processing Policy Revisions for 2025
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D4268: This procedure is considered a component of the surgical procedure (D4240, D4241, D4260, and D4261) and a separate fee is NOT BILLABLE TO THE PATIENT.
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D8670: Fees for D8670 are NOT BILLABLE to the PATIENT when done on the same date of service as D8671.
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D9994: Benefits for patient education are DENIED. Fees for patient education to improve oral health literacy are NOT BILLABLE TO THE PATIENT when submitted on same date of service as D1301, D1310, D1320, D1321 and D1330.