Understanding Dental Code D9975

When to Use D9975 dental code

The D9975 dental code is designated for external bleaching for home application, per arch, and includes both the materials and the fabrication of custom trays. This CDT code should be used when a patient receives a take-home whitening kit that is professionally dispensed and customized by the dental office. D9975 is not intended for in-office bleaching procedures or over-the-counter whitening products. Correct usage of this code ensures accurate billing and helps avoid insurance denials or patient confusion.

Documentation and Clinical Scenarios

Proper documentation is essential when billing D9975. Dental teams should record the patient’s initial shade, the reason for bleaching (such as esthetic concerns or pre-prosthetic treatment), and the fabrication of custom trays. Include details about the materials provided (e.g., type and concentration of bleaching gel) and instructions given to the patient. Clinical scenarios for D9975 include:

• Patients seeking cosmetic improvement with take-home whitening kits.
• Pre-prosthetic cases where shade matching is required for crowns or veneers.
• Patients with intrinsic staining who are not candidates for in-office bleaching.

Always ensure that the patient’s informed consent is documented, and retain photos or shade guides in the clinical record to support the necessity and delivery of the service.

Insurance Billing Tips

Most dental insurance plans consider external bleaching an elective, cosmetic procedure and do not provide coverage for D9975. However, submitting the code with complete documentation is still best practice for transparency and patient records. When billing:

• Verify the patient’s insurance benefits before treatment and inform them of likely out-of-pocket costs.
• Submit a pre-authorization if the patient requests it, even if coverage is unlikely, to provide a clear EOB (Explanation of Benefits).
• Clearly itemize the bleaching materials and custom tray fabrication in your claim narrative.
• If D9975 is denied, provide patients with a copy of the EOB and discuss payment options.

For offices that bundle bleaching with other restorative procedures, ensure that each service is billed separately and supported by documentation. If you are billing for in-office bleaching, consider using the appropriate code, such as D9972 for in-office bleaching per arch.

Example Case for D9975

Consider a patient who is preparing for anterior crowns and requests a whiter smile. The dentist recommends external bleaching to achieve a lighter shade before final crown selection. The office takes impressions, fabricates custom trays, and dispenses a professional-grade whitening gel for home use. The clinical notes include pre- and post-treatment shade documentation, patient instructions, and informed consent. The billing team submits D9975 for each arch treated, with a narrative explaining the esthetic rationale and the materials provided. The claim is processed, and although insurance denies coverage, the patient receives a clear EOB and pays the agreed fee, satisfied with the outcome and transparency.