Understanding Dental Code D9990

When to Use D9990 dental code

The D9990 dental code is designated for certified translation or sign-language services provided to patients during a dental visit. This CDT code is used when a dental office arranges and documents professional language assistance—either through a certified translator or a qualified sign-language interpreter—to ensure effective communication and informed consent. D9990 should be applied per visit, not per procedure, and only when the service is necessary for the patient to fully understand their treatment options, risks, and post-care instructions.

Documentation and Clinical Scenarios

Accurate documentation is crucial when billing D9990. Dental teams should record the following in the patient’s chart:

• Date and time of the service
• Name and credentials of the interpreter or translator
• Language or sign-language provided
• Reason the service was required (e.g., patient’s primary language, hearing impairment)
• Summary of the communication facilitated

Common clinical scenarios include:

• New patient exams where the patient is not fluent in English
• Complex treatment plan discussions requiring informed consent
• Post-operative instructions for patients with limited English proficiency or hearing impairment

Thorough documentation not only supports claim submission but also protects the practice in case of audits or claim appeals.

Insurance Billing Tips

While D9990 is a valid CDT code, not all dental benefit plans reimburse for translation or sign-language services. Here are best practices for maximizing reimbursement and minimizing denials:

• Verify coverage: During insurance verification, ask payers if D9990 is a covered benefit and if pre-authorization is required.
• Submit detailed claims: Include supporting documentation and a clear narrative explaining why the service was medically necessary.
• Use accurate coding: Only bill D9990 for certified services. Avoid using it for informal translation by staff or family members.
• Appeal denials: If a claim is denied, review the EOB for denial reasons and submit a claim appeal with additional documentation, such as a letter of medical necessity and interpreter credentials.

Proactive communication with payers and patients about potential out-of-pocket costs is also recommended.

Example Case for D9990

Consider a scenario where a patient who is deaf presents for a comprehensive exam and treatment planning. The dental office arranges for a certified American Sign Language interpreter to be present. The interpreter facilitates communication throughout the visit, ensuring the patient understands the diagnosis, proposed procedures, and post-care instructions. The office documents the interpreter’s details, the language provided, and the necessity for the service. When submitting the claim, the office includes D9990 with supporting documentation. If the payer denies the claim, the office follows up with a detailed appeal, including the interpreter’s certification and a narrative outlining the importance of effective communication for patient safety and informed consent.

By following these steps, dental practices can ensure compliance, support patient-centered care, and optimize reimbursement for essential language services.