D0425

Caries Susceptibility Tests - CDT Code Guide

Diagnostic/Tests and Examinations

Overview

CDT code D0425 refers to caries susceptibility tests, which are diagnostic procedures used to assess a patient's risk of developing dental caries. These tests are crucial in preventive dental care, allowing dentists to tailor treatment plans based on individual risk factors. Typically, the procedure involves collecting samples of saliva or plaque to analyze the presence of bacteria that contribute to tooth decay. This code should not be used for procedures involving carious dentin staining. Caries susceptibility tests are particularly beneficial for patients with a history of frequent cavities, those with orthodontic appliances, or individuals with dry mouth conditions.

When to Use This Code

  • Patients with a history of frequent cavities
  • Individuals undergoing orthodontic treatment
  • Patients with dry mouth or reduced salivary flow
  • Children with high sugar diets
  • Adults with poor oral hygiene habits

Documentation Requirements

  • Patient's dental and medical history
  • Clinical notes on the rationale for testing
  • Results of the caries susceptibility test
  • Treatment plan based on test results
  • Patient consent for the procedure

Billing Considerations

Caries susceptibility tests may be subject to frequency limitations, often covered once per year by insurance. It's important to check with the patient's insurance provider for specific coverage details. Common modifiers may include those indicating preventive services. Ensure documentation is thorough to support the necessity of the test.

Related CDT Codes

Frequently Asked Questions

The test helps determine a patient's risk of developing cavities, allowing for personalized preventive care.

Source: CDT 2023 © American Dental Association

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