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ADA Broadens the Definition of Porcelain/Ceramics in the CDT Code

Posted on June 18, 2012

ST. PAUL, Minn. – June 13, 2012 – In response to requests from 3M ESPE and the dental community, the ADA will broaden its definition of porcelain/ceramic materials in its CDT Code for insurance reimbursement, allowing 3M™ ESPE™ Lava™ Ultimate Restorative to be classified as a porcelain/ceramic. The change will be effective January 1, 2013, making it possible for dentists who use the material to easily file for insurance reimbursement, including using CDT code D2740 for crowns.

Lava Ultimate restorative is an innovative new material formulated from a blend of approximately 80 percent nanoceramic particles embedded in a highly-cured resin matrix using a proprietary 3M manufacturing process. The material is available for chairside milling using CEREC® or E4D® systems or can be ordered as a finished restoration from Authorized Lava Milling Centers, Jensen Milling Centers and Straumann CARES® Digital Solutions.

At the time the material was launched, the ADA’s CDT Code nomenclature did not yet reflect the advances in material science that Lava Ultimate restorative represents, resulting in challenges with selecting the proper CDT code for insurance reimbursement. However, following a formal request from 3M ESPE, the ADA has now broadened the material definition of indirect porcelain/ceramic restorations. With this change, Lava Ultimate restorative will fall under any CDT code defined for ceramics, allowing for the same  rate of reimbursement as other ceramic materials. The new CDT Code definition reads:

 

Porcelain/ceramic

Refers to the pressed, fired, polished or milled materials containing predominantly inorganic refractory compounds — including porcelains, glasses, ceramics and glass-ceramics.

 

"By broadening the definition of porcelain/ceramics in the CDT Code, the ADA's Council on Dental Benefits is making the benefits of advanced material science accessible to more patients,” said John Stefanick, director of industry & professional relations, 3M ESPE. “This CDT Code change will be welcomed by many dentists.”

The streamlined insurance reimbursement enabled by the revised definition of glass ceramics in the nomenclature of the CDT Code will make it even easier for dentists to take advantage of Lava Ultimate restorative’s unique functionality, providing restorations that are strong as well as kind to opposing dentition. The restorations can be repaired intraorally if necessary, and are backed by a 10-year warranty from 3M ESPE. With the ability to code Lava Ultimate restorative like other porcelain/ ceramic materials for insurance reimbursement, now even more dentists and patients can experience the outstanding qualities of this material.  

New nomenclature applies to all porcelain/ceramic CDT codes including D2740 for crowns and codes for inlays/onlays

For more information about Lava Ultimate Restorative and how it will fit under the porcelain/ceramic codes  in the CDT code, visit www.3mespe.com/LavaUltimate.