Understanding Dental Code D8660

Dental billing teams and office managers frequently encounter CDT codes that require precise application and documentation for accurate insurance reimbursement. One such code is D8660, which covers the pre-orthodontic treatment examination to monitor growth and development. Understanding when and how to use the D8660 dental code is essential for maximizing reimbursement and ensuring compliance with payer requirements.

When to Use D8660 dental code

The D8660 dental code is used for a pre-orthodontic treatment examination specifically aimed at monitoring a patient’s growth and dental development. This code is appropriate when a dentist or orthodontist evaluates a patient—often a child or adolescent—who is not yet ready for active orthodontic treatment, but whose dental and skeletal development needs to be tracked over time.

Key scenarios for using D8660 include:

• Initial orthodontic consultations where treatment is not immediately indicated
• Periodic follow-up visits to assess changes in occlusion, jaw growth, or eruption patterns
• Monitoring patients with developing malocclusions or craniofacial discrepancies

It is important not to confuse D8660 with codes for active orthodontic treatment or comprehensive exams. For example, if you are billing for a comprehensive orthodontic evaluation, refer to D8080 for adolescent comprehensive orthodontic treatment.

Documentation and Clinical Scenarios

Accurate and thorough documentation is critical when billing D8660. Best practices include:

• Detailing the patient’s dental and skeletal development status in the clinical notes
• Recording specific findings such as eruption sequences, jaw relationships, and any developing malocclusion
• Documenting the rationale for monitoring instead of initiating treatment
• Noting any recommendations for home care or future follow-up intervals

Example clinical scenario: A 9-year-old patient presents with mild crowding and a Class II skeletal relationship. The orthodontist determines that immediate treatment is not warranted but recommends periodic monitoring every 6–12 months to assess growth and determine the optimal timing for intervention. D8660 is the appropriate code for these monitoring visits.

Insurance Billing Tips

Proper billing of D8660 can help avoid denials and delays in accounts receivable (AR). Consider these actionable tips:

• Verify coverage: Always check the patient’s dental insurance plan for orthodontic benefits and specific coverage for pre-orthodontic exams.
• Submit detailed narratives: Include a concise narrative explaining why monitoring is necessary and what was evaluated during the visit.
• Attach supporting documentation: Upload clinical notes, growth charts, and any diagnostic images to support the claim.
• Track EOBs: Review Explanation of Benefits (EOBs) carefully for denial reasons and be prepared to submit claim appeals with additional documentation if needed.
• Stay updated: Regularly review payer guidelines, as coverage for D8660 can vary by plan and region.

Example Case for D8660

Consider a dental office that sees a 10-year-old patient referred by a general dentist for orthodontic evaluation. The orthodontist documents a mixed dentition stage with mild anterior crowding and a developing crossbite. Rather than starting braces immediately, the provider schedules monitoring visits every 8 months to observe jaw growth and tooth eruption. Each monitoring visit is billed using D8660, with clinical notes and growth assessments attached to each claim. The insurance plan covers two D8660 visits per year, and the office receives timely reimbursement by following best billing practices and maintaining thorough documentation.

By understanding the intent and requirements of the D8660 dental code, dental practices can ensure accurate billing, support optimal patient care, and maintain a healthy revenue cycle.