When is D9973 used?
The D9973 dental code applies to external tooth bleaching treatments, billed per arch. This CDT code is appropriate when patients choose professional teeth whitening for aesthetic purposes, with bleaching agents applied to the outer enamel surface. D9973 does not cover internal bleaching for non-vital teeth or take-home whitening kits sold by the practice. This code should only be used for professional-grade treatments performed or overseen by licensed dental practitioners.
D9973 Charting and Clinical Use
Proper documentation ensures correct billing and regulatory compliance. When applying D9973, your patient records should contain:
Comprehensive clinical notes recording the patient's starting tooth shade and treatment goals
Specific bleaching product and concentration utilized
Documentation of treated arches (upper, lower, or both)
Signed patient consent for elective treatment
Before and after treatment images (when available)
Typical clinical situations for D9973 involve patients wanting cosmetic enhancement for important events like weddings or professional opportunities, or individuals concerned about tooth staining from aging, dietary habits, or medications. Always emphasize that this represents an optional, aesthetic procedure, which affects insurance reimbursement eligibility.
Billing and Insurance Considerations
The majority of dental insurance policies exclude coverage for external bleaching treatments coded as D9973, classifying them as cosmetic procedures. Nevertheless, verifying individual patient benefits before treatment remains essential. Follow these practical billing guidelines for D9973:
Benefit Verification: Contact the patient's insurance provider or access their online system to determine if cosmetic coverage exists.
Treatment Estimates: File a pre-authorization request to receive official coverage determination, improving patient understanding and treatment acceptance.
Patient Education: Discuss expected costs clearly and secure written financial consent before beginning treatment.
Claims Processing: When filing claims, apply D9973 with complete supporting records, even when reimbursement seems unlikely. This maintains proper documentation for practice and patient records.
EOB Management: Process Explanation of Benefits statements quickly. File any coverage denials for future reference and patient discussions.
How dental practices use D9973
A 35-year-old patient seeks professional whitening treatment prior to an important personal milestone. Following a thorough examination, the dentist confirms the patient's suitability for external bleaching. The practice records baseline tooth shade, reviews expected results, and secures informed consent. Insurance verification confirms that whitening procedures lack coverage benefits. After cost discussion and patient agreement, the dental team completes external bleaching treatment on both arches using professional-grade whitening gel, documents the service with D9973, and provides aftercare guidance. Claims are filed for record-keeping purposes, with the coverage denial maintained in the patient file for transparency.
Following these protocols helps dental practices maintain accurate billing practices, effective patient communication, and thorough documentation when utilizing D9973 for external bleaching services.
Common Questions
Is D9973 suitable for touch-up treatments or additional bleaching sessions?
D9973 can indeed be utilized for touch-up appointments or subsequent external bleaching treatments, provided that each session receives proper documentation and is billed on a per-tooth basis. Every treatment instance must include comprehensive clinical documentation, current shade records, and updated patient consent forms. It's important to confirm with patients and their insurance providers regarding any available benefits or restrictions that may apply to repeated bleaching procedures.
What patient conditions or factors would make D9973 inappropriate for use?
Several patient conditions may make external bleaching inadvisable, including pregnancy, nursing mothers, significant enamel deterioration, extreme tooth sensitivity, or active dental caries that remain untreated. Dental practitioners must conduct comprehensive patient assessments to confirm candidacy for external bleaching treatments prior to implementing D9973 procedures.
What approach should dental practices take when patients express dissatisfaction with D9973 bleaching outcomes?
When patients express concerns about their bleaching results, dental practices should carefully examine the initial shade records, engage in thorough discussions about achievable outcomes, and reference the patient's signed consent documentation. Any follow-up treatments must receive proper documentation and appropriate billing codes. Establishing clear communication protocols both before and following treatment helps set appropriate patient expectations and minimizes potential conflicts.