When is D9990 used?
The D9990 dental code applies to certified translation or sign-language interpretation services delivered to patients during dental appointments. This CDT code is utilized when dental practices coordinate and record professional language support—through certified translators or qualified sign-language interpreters—to guarantee clear communication and proper informed consent. D9990 is billed per appointment rather than per procedure, and only when such services are essential for patients to completely comprehend their treatment choices, associated risks, and aftercare guidelines.
D9990 Charting and Clinical Use
Proper documentation is essential when submitting claims for D9990. Dental staff should include the following information in patient records:
Service date and time
Interpreter or translator name and qualifications
Specific language or sign-language interpretation provided
Justification for the service requirement (e.g., patient's native language, hearing disability)
Overview of the communication assistance provided
Typical clinical situations include:
Initial patient evaluations for non-English speaking patients
Detailed treatment planning conversations requiring proper consent
Post-treatment care instructions for patients with language barriers or hearing challenges
Complete documentation supports claim processing and safeguards the practice during audits or claim reviews.
Billing and Insurance Considerations
Although D9990 is an accepted CDT code, many dental insurance plans do not cover translation or interpretation services. Consider these strategies for improving reimbursement and reducing claim rejections:
Check benefits: During benefit verification, confirm with insurers whether D9990 is covered and if prior authorization is needed.
Provide comprehensive claims: Attach supporting documents and clear explanations of why the service was clinically necessary.
Code precisely: Bill D9990 exclusively for certified professional services. Do not use for casual translation by employees or relatives.
Challenge rejections: When claims are denied, examine the explanation of benefits for reasons and file appeals with additional evidence, including necessity letters and interpreter qualifications.
Clear communication with insurers and patients regarding potential personal expenses is also advisable.
How dental practices use D9990
Imagine a situation where a hearing-impaired patient arrives for a thorough examination and treatment consultation. The dental practice secures a certified American Sign Language interpreter for the appointment. The interpreter enables communication during the entire visit, making sure the patient grasps the diagnosis, recommended treatments, and follow-up care instructions. The practice records the interpreter's information, the communication method used, and the reason for requiring the service. When filing the claim, the practice submits D9990 along with supporting materials. Should the insurer reject the claim, the practice responds with a comprehensive appeal, including interpreter certification and documentation explaining why effective communication is vital for patient safety and proper consent.
Following these guidelines helps dental practices maintain compliance, deliver patient-focused care, and maximize reimbursement for crucial language assistance services.
Common Questions
Can D9990 be billed when family members or staff provide interpretation services?
No, D9990 is exclusively for certified interpreter services. Family members or untrained staff members do not qualify as certified interpreters, and their interpretation services cannot be billed under this code.
How frequently can D9990 be billed for a single patient?
D9990 may be billed for each separate visit where certified interpreter services are medically necessary. However, it cannot be billed multiple times during a single appointment or for non-clinical conversations. Be sure to verify any payer-specific restrictions on billing frequency.
Do dental practices have legal obligations to provide interpreter services?
Yes, federal regulations and many state laws mandate that healthcare providers, including dental offices, must provide language assistance to patients with limited English proficiency or communication disabilities. Although not all insurance plans cover D9990, offering interpreter services is typically both a legal requirement and ethical responsibility to ensure proper patient communication and care.