The American Dental Association (ADA) has announced 60 total changes for the 2026 version of the CDT code set: 31 new codes, 14 revisions, 6 deletions, and 9 editorial clarifications.
Effective date: January 1, 2026.
Yes, your team needs to get ready now.

These updates are more than cosmetic. They reflect evolving technologies (like point-of-care saliva testing), new treatment modalities (like cracked tooth testing and occlusal-guard maintenance), and even a “sweeping overhaul” of the anesthesia codes.

Why should you care? Because if your practice keeps using old codes (or misuses the new ones), you not only risk denials, you might also let insurance companies dictate how your treatment is defined. And that’s a slippery slope.

Spotlight on Key New & Revised Codes

1. Point-of-care saliva testing
   New codes have been added for in-office saliva diagnostics.
   If your hygienist or dentist performs a saliva-based test and you bill using an older “lab only” code, you could get flagged.
   Update your code library and make sure your notes reflect “in-office” and “point-of-care.”

2. Resin-based composite restorations revision
   The descriptor for D2391 (one-surface posterior composite) changed, removing the “lesion depth” language. D1352 (preventive resin restoration) is deleted because D2391 now covers it.
   Keep using D1352 after Jan 1 and you’ll see denials. Update references, retrain your restorative team, and clean up your software.

3. Denture/occlusal-guard maintenance and duplication
   New codes cover denture duplication (maxillary and mandibular) and cleaning & inspection of occlusal guards.
   These fill gaps for services you’ve probably been doing without the right codes. Using an old “closest code” invites payer pushback.

4. Anesthesia codes overhaul
   Anesthesia codes are being restructured. This is already a denial-heavy category, so update everything. Hold training for sedation coordinators and make sure your forms and modifiers line up.

5. Other notable additions
   Cracked tooth syndrome testing, implant maintenance, and photobiomodulation therapy all get their own spotlight. These changes match what’s happening clinically and help justify what you bill.

Why Insurers (So) Love to Disallow or Downcode

Insurers love new codes because they create excuses to deny, downcode, or bundle. Bundling and downcoding basically mean you perform a specific service, bill the right code, and the payer decides to pay you less anyway.

They do it because:
• They don’t update their systems quickly.
• New codes cost them more.
• They use descriptor confusion to justify denials.
• They claim “unlisted procedure” or “not recognized.”

Classic triggers of denials
• Using old codes after January 1.
• Documentation doesn’t match the new descriptor.
• The payer hasn’t loaded the new code yet.
• Benefits don’t cover the new code.

Best Practices for Adoption & Claim-Defense

Start preparing now. Preorder the CDT 2026 manual, update your software, and train your entire team. Make sure documentation clearly matches the new descriptors.

Create a log of new codes and track denials for each one. If you see patterns, investigate. If you’re out-of-network, you might need to renegotiate.

Also, prep your front desk for patient conversations about cost changes tied to new codes. Use this as a teaching moment instead of an awkward surprise.

Fun (Really!) Case Study: “Cracked tooth syndrome”

Dr. Lee tests for cracked tooth syndrome and bills the new 2026 code. The payer denies it as “unlisted.” Dr. Lee appeals with documentation and cites the ADA descriptor. Eventually, it gets approved.

That’s the point of readiness. If you wait until January 2, you’ll be scrambling while insurers tighten their filters.

Conclusion: Bringing It All Together

CDT 2026 isn’t just a yearly update, it’s a chance to tighten your workflow. Train your team, document precisely, track denials, and review your insurance contracts.

Change brings clarity. The more accurately you code, the harder it is for insurers to control your narrative.

Here’s to a smooth rollout of CDT 2026—clean claims, fewer denials, and a stronger bottom line.

Benjamin Tuinei
Founder – Veritas Dental Resources, LLC
📞 888-808-4513
Services: PPO Fee Negotiators, PPO Fee Negotiating, Insurance Fee Negotiating, Insurance Credentialing, Insurance Verifications
Websites: www.VeritasDentalResources.com, www.VerusDental.com