Understanding Dental Code D8670

When to Use D8670 dental code

The D8670 dental code is designated for a “Periodic orthodontic treatment visit.” This CDT code is used to report routine, recurring appointments during active orthodontic treatment, such as adjustments, wire changes, or monitoring progress. It is not intended for the initial placement of appliances or final removal; instead, it covers the ongoing visits that ensure treatment is progressing as planned. Dental offices should use D8670 for each periodic visit that involves active orthodontic care, typically scheduled every 4–8 weeks, depending on the patient’s treatment plan.

Documentation and Clinical Scenarios

Accurate documentation is essential for proper billing and insurance reimbursement. For each D8670 encounter, chart the specific procedures performed—such as archwire adjustments, bracket checks, or elastics changes—and note any patient-specific observations or instructions. Common clinical scenarios for D8670 include:

• Routine adjustment of orthodontic appliances
• Monitoring tooth movement and progress
• Replacing or tightening wires and elastics
• Addressing minor appliance repairs during active treatment

Ensure that each visit note clearly supports the use of D8670, including the date, provider, and details of the orthodontic intervention. This documentation is critical for insurance audits and claim appeals.

Insurance Billing Tips

To maximize reimbursement and minimize denials when billing D8670, follow these best practices:

• Verify orthodontic benefits before treatment begins, including frequency limitations and lifetime maximums.
• Submit a comprehensive orthodontic treatment plan with the initial claim, outlining the expected number of periodic visits.
• Bill D8670 for each qualifying visit as treatment progresses, ensuring each claim is supported by clinical notes.
• Review Explanation of Benefits (EOBs) promptly to track payments and identify any discrepancies.
• If a claim is denied, appeal with detailed documentation showing the necessity and nature of the periodic visit.

Some payers may bundle periodic visits into a global orthodontic fee, while others require itemized billing for each D8670 encounter. Always check payer guidelines and update your billing protocols accordingly.

Example Case for D8670

Consider a 14-year-old patient in active braces treatment. At a scheduled six-week follow-up, the orthodontist replaces the archwire, checks bracket integrity, and provides new elastics. The clinical note documents the adjustments, patient compliance, and oral hygiene instructions. For this visit, the office bills D8670, attaching the detailed progress note to the claim. The insurance plan allows periodic visits every 30 days, so the claim is processed and paid without issue. If the plan had a frequency limitation, the office would reference the treatment plan and appeal if necessary, using the thorough documentation from the visit.

By understanding the correct use of D8670 and maintaining robust documentation, dental teams can ensure accurate billing, smooth insurance workflows, and optimal revenue cycle management.