Efforts by ADHA Make Impact on ADA Code Reversal Decision

Mar 20, 2003, 00:00 ET from American Dental Hygienists' Association

    CHICAGO, March 20 /PRNewswire/ -- The American Dental Hygienists'
 Association is pleased to announce that in response to efforts by ADHA, the
 American Dental Association's Committee on Code Revision has reversed
 problematic language in ADA's Current Dental Terminology, fourth edition
 (CDT-4) manual, which became effective January 1, 2003.
     On that date, a number of changes were made to the previous insurance
 reporting codes for dental procedures (CDT-3), which ADHA believes created a
 potentially damaging situation for oral health care consumers.
     CDT codes are the recognized dental insurance codes for the entire U.S.
 and are used by private insurers, Medicaid and other third-party payers. The
 codes are updated every two years, with the revisions effective at the start
 of the following calendar year.
     The previous definition defined the adult prophylaxis (teeth cleaning) as
 scaling AND polishing to remove coronal plaque, calculus and stains, while the
 new definition that took effect in January referred to scaling AND/OR
     According to ADHA President Kimberly K. Benkert, "This seemingly minor
 change represented a major potential threat to the safety and welfare of the
 public. The potential harm to the patient is quite clear. Scaling to remove
 calculus is the preventive element of the prophylaxis, while polishing is a
 selective cosmetic and esthetic addition to the scaling procedure and has no
 therapeutic value in preventing or treating periodontal (gum) disease."
     Benkert adds that ADHA's concern with this perceived minor change is that
 it would allow practitioners in states to submit polishing services as a
 complete and therapeutic prophylaxis.
     "It was our position that this would be both misleading and risky for
 consumers, who might be unaware that a polishing is not a complete
 prophylaxis," said Benkert.
     In response to CDT-4 changes, ADHA initiated several proactive measures to
 effect a reversal decision. Today's announcement demonstrates the positive
 results of these actions.
     Letters were sent to every state dental board, state consumer protection
 agencies, dental hygienist members of state dental boards, and state dental
 hygiene association presidents. In addition, ADHA published an article on
 CDT-4 in its January 2003 issue of Access, a national magazine that focuses on
 health and practice news, professional issues, and legislative developments
 that are important to dental hygienists. Finally, ADHA staff were represented
 at the ADA's Code Revision Committee (ADA CRC) meeting in February. At the
 meeting, ADA CRC reversed the language to correctly reflect the minimum level
 of quality care and protection of the public in CDT-3.
     "We still have concerns with the way the prophylaxis code in CDT-4 is
 worded. In particular, we are concerned with the use of the word 'coronal',
 which does not address scaling below the gumline," said Tammi O. Byrd, ADHA
 president-elect. "ADHA will be taking steps to request further clarification
 of this language."
     The primary purpose of ADHA's efforts was to bring attention to this issue
 with ADA, state boards and state consumer protection offices on an issue that
 could have detrimental effects on the most important element, the oral health
 of the consumer, as well as third-party insurers and dental hygienists.
     "ADHA is delighted with ADA's decision to reverse CDT-4, due to the
 successful efforts of its staff and leadership," said Benkert. "The initial
 code revision to 'and/or' was more than just an insurance issue, it created an
 ethical dilemma and a potentially harmful effect on the quality of patient
     ADHA is the largest national organization representing the professional
 interests of the more than 120,000 dental hygienists across the country.
     Dental hygienists are preventive oral health professionals, licensed in
 dental hygiene, who provide educational, clinical and therapeutic services
 that support total health through the promotion of optimal oral health.
     For more information about ADHA, dental hygiene or the link between oral
 health and general health, visit ADHA at http://www.adha.org .

SOURCE American Dental Hygienists' Association