Understanding Dental Code D9996

When to Use D9996 dental code

The D9996 dental code is designated for teledentistry services performed asynchronously, meaning patient information—such as radiographs, photographs, or digital impressions—is collected and securely transmitted to a dentist for evaluation at a later time. This code should be used when there is no real-time interaction between the patient and the dentist. Common scenarios include remote consultations for second opinions, triage of dental emergencies, or follow-up assessments where the dentist reviews stored data and provides recommendations without a live video or phone call.

Documentation and Clinical Scenarios

Accurate documentation is essential when billing D9996. The patient’s record must clearly indicate:

• The type of information collected (e.g., intraoral photos, radiographs, health history).
• The date and method of data collection and transmission.
• The dentist’s subsequent review, findings, and recommendations.

Typical clinical scenarios include a hygienist collecting images during a school screening, which are then sent to a dentist for review, or a patient uploading photos of a post-operative site for the dentist to assess healing. In both cases, the dentist reviews the information at a later time and documents their findings and any follow-up instructions.

Insurance Billing Tips

When submitting claims for D9996, follow these best practices to maximize reimbursement and minimize denials:

• Verify coverage: Not all dental payers reimburse for teledentistry. Confirm benefits with each patient’s plan before providing the service.
• Use the correct CDT code: D9996 specifically covers asynchronous teledentistry. Do not confuse it with D9995, which is for synchronous (real-time) teledentistry.
• Submit supporting documentation: Attach clinical notes, images, and a narrative describing the reason for the asynchronous review.
• Track EOBs and AR: Monitor Explanation of Benefits (EOBs) for correct processing and follow up on accounts receivable (AR) promptly if claims are denied or underpaid.
• Appeal if necessary: If a claim is denied, submit a detailed appeal with documentation showing medical necessity and the value of the asynchronous review.

Example Case for D9996

Consider a pediatric patient who sustains a minor dental injury at school. The school nurse collects intraoral photographs and a brief medical history, then forwards the information to the dental office. The dentist reviews the materials after clinic hours, determines that no immediate intervention is needed, and sends recommendations for home care. In this case, D9996 is the appropriate code to bill for the dentist’s asynchronous review and professional judgment.

By understanding when and how to use D9996, dental teams can expand access to care, streamline workflows, and ensure accurate reimbursement for teledentistry services.