When is D8660 used?
Dental billing professionals and practice administrators regularly work with CDT codes that demand accurate implementation and proper documentation to secure appropriate insurance payments. The D8660 code addresses pre-orthodontic treatment evaluations focused on monitoring patient growth and development. Mastering the proper application of the D8660 dental code is crucial for optimizing reimbursement rates and maintaining compliance with insurance provider standards.
When is D8660 used?
The D8660 dental code applies to pre-orthodontic treatment evaluations designed to track patient growth and dental development progress. This code fits situations where a dentist or orthodontist assesses a patient—typically a child or teenager—who isn't ready for immediate orthodontic intervention, but requires ongoing developmental monitoring.
Primary applications for D8660 include:
First-time orthodontic consultations where immediate treatment isn't recommended
Regular follow-up appointments to evaluate occlusion changes, jaw development, or tooth eruption patterns
Tracking patients with emerging malocclusions or craniofacial irregularities
Avoid mixing up D8660 with codes for active orthodontic procedures or complete examinations. When billing for a full orthodontic assessment, consider D8080 for comprehensive adolescent orthodontic care.
D8660 Charting and Clinical Use
Comprehensive and precise documentation remains essential when submitting D8660 claims. Recommended practices include:
Recording the patient's dental and skeletal development progress in clinical records
Documenting specific observations like tooth eruption timing, jaw positioning, and any emerging bite problems
Explaining why monitoring is chosen over immediate treatment initiation
Including home care suggestions and future appointment scheduling recommendations
Clinical example: A 9-year-old patient shows minor crowding with a Class II skeletal pattern. The orthodontist decides immediate treatment isn't necessary but suggests regular monitoring every 6–12 months to track development and identify the best treatment timing. D8660 correctly codes these monitoring appointments.
Billing and Insurance Considerations
Correct D8660 billing helps prevent claim rejections and reduces accounts receivable delays. Follow these practical guidelines:
Confirm benefits: Always verify the patient's dental insurance coverage for orthodontic services and pre-orthodontic examination benefits.
Provide detailed explanations: Include clear narratives describing why monitoring is needed and what was assessed during the appointment.
Include supporting materials: Submit clinical documentation, development charts, and diagnostic images to strengthen the claim.
Monitor claim responses: Carefully review Explanation of Benefits statements for rejection reasons and prepare appeals with additional documentation when necessary.
Maintain current knowledge: Regularly check payer policies, as D8660 coverage varies between plans and locations.
How dental practices use D8660
A dental practice evaluates a 10-year-old patient referred by their family dentist for orthodontic consultation. The orthodontist notes mixed dentition with slight front tooth crowding and a developing crossbite. Instead of beginning braces treatment, the provider arranges monitoring appointments every 8 months to track jaw development and tooth emergence. Each monitoring session uses D8660 billing, supported by clinical documentation and development records. The insurance plan approves two D8660 visits annually, and the practice receives prompt payment through proper billing procedures and complete documentation.
Understanding the purpose and requirements of the D8660 dental code helps dental practices achieve accurate billing, deliver excellent patient care, and maintain strong financial performance.
Common Questions
Can D8660 be billed alongside other orthodontic procedures during the same appointment?
D8660 is generally billed as an independent code for pre-orthodontic treatment evaluations. When additional procedures or diagnostic services (like X-rays or dental impressions) are completed during the same appointment, these services can be billed separately using their appropriate codes. It's essential to prevent duplicate billing for identical services and always verify payer-specific guidelines regarding bundling restrictions or frequency limits.
Is D8660 restricted to children and teens, or is it applicable for adult patients?
Although D8660 is primarily utilized for children and adolescent patients given its emphasis on growth and development monitoring, it may be applied to adult patients in specific situations where tracking skeletal or dental modifications is clinically warranted. Comprehensive documentation should clearly outline the reasoning for utilizing D8660 in adult cases to demonstrate medical necessity and support insurance authorization.
What is the billing frequency allowed for D8660 per patient?
The billing frequency for D8660 is determined by the clinical requirement for growth and development monitoring, typically occurring every 6–12 months. Insurance providers may impose their own frequency restrictions or specific requirements, making it crucial to confirm coverage details and document clinical necessity for each appointment. D8660 should not be used for standard recall examinations unless there is a documented orthodontic monitoring requirement.