Ah yes, Current Dental Terminology—the sacred scroll of dentistry. The Rosetta Stone of reimbursement. The ultimate guide to understanding what you can and can’t bill for… or so we thought.

Crafted and copyrighted by none other than the American Dental Association, the CDT code set is supposed to be the gold standard for accurately describing dental procedures. It gets updated yearly with shiny new codes that reflect advances in treatment, technology, and what patients actually need.

But here’s the plot twist, folks: insurance companies don't care.

That’s right. Insurance plans routinely look at these shiny new ADA-approved codes and say, “Cute. We’ll take none of that.”

Welcome to the Dental Insurance Twilight Zone, where:

• Procedures get codes,

• Codes get submitted,

• And insurance says, “Yeah… we’re gonna go ahead and disallow that.”

The ADA Writes the Book. Insurance Rips Out the Pages.

Let’s get something straight. The ADA owns the CDT coding system. They are the ones responsible for creating, approving, and releasing new codes every year. These codes are meant to help dentists describe procedures more accurately, document patient care, and (theoretically) get reimbursed fairly.

But here’s the kicker:

Just because the ADA creates a code doesn’t mean insurance companies will reimburse for it.

In fact, many new codes go directly onto insurance companies’ “disallowed” lists. That’s like inventing a new flavor of ice cream only for your freezer to ban it.

“Sorry, you can’t charge for this new bone grafting technique we just coded—even though it took you three hours, advanced equipment, and postgraduate training. But hey, thanks for documenting it!”

So What’s the Point of New Codes Then?

Great question. Dentists everywhere are asking the same thing.

What’s the point of developing new codes for emerging procedures when insurance plans just plug their ears and chant “DENIED!”?

It’s like:

• Building a brand-new luxury hotel...

• Letting guests book a room…

• And then telling them the elevators don’t go to those floors.

And before anyone says, “Well, the ADA is doing their best,” sure, we hear you. But dentists are still left staring at their EOBs wondering how their jaw-dropping, smile-restoring, life-changing procedure got reduced to $0 payable with a side note that reads: "This code is not a covered benefit under the plan.”

Doesn’t matter if it’s elective, medically necessary, or the dental equivalent of defusing a bomb—if insurance didn’t pre-approve it, or worse, doesn’t recognize the code, you’re either working for minimum wage or… wait for it… for free.

Imagine Doing God’s Work... for Free.

Let’s get real. Dentists don’t see themselves as billing machines. They see themselves as healers. Restorers. Life-changers.

You take someone in pain, embarrassed to smile, barely able to eat—and you restore function, confidence, and health.

That’s sacred work.

But try billing a code for that implant-supported hybrid restoration and you’ll get back a lovely denial that says something like:

“We do not recognize this code. This procedure is not reimbursable under the member’s current benefit plan.”

Translation: “We know you just changed this person’s life, but we’ll be compensating you the same as someone who flossed a little too hard.”

CDT 2025: Codes, Codes Everywhere—But Not a Dollar to Bill

This year’s CDT code updates include multiple new codes for digital workflows, 3D printing, advanced imaging, and updated perio classifications.

They reflect the reality of modern dentistry. Except the reality of insurance is still stuck somewhere around 1987.

You can 3D scan, digitally plan, laser prep, and nanocomposite restore, but if there’s a new code attached to it, insurance sees it as an inconvenience. Or worse, as a loop-hole-closing opportunity.

“Ah, a new code for this? Great. We’ll go ahead and exclude that from your in-network reimbursement schedule. You’re welcome.”

So, What Can Dentists Do?

Dentists across the country are tired of this game. And the only thing worse than playing a game you can’t win is doing it silently.

Here’s how practices are fighting back—and staying profitable:

Go Out-of-Network (A.K.A. Go Unrestricted)

Stop letting insurance dictate your treatment, your value, and your worth. Dentists are increasingly leaving restrictive networks so they can charge fairly for procedures regardless of what the insurance manual from 1992 says.

Educate Your Team (and Your Patients)

Train your front office to explain why insurance disallows certain procedures and how patients can still use their benefits while paying you directly for quality care.

Use Resources That Work

Stay sharp. Tools like Coding with Confidence by Dr. Charles Blair help you code correctly and advocate for claims that insurance companies love to push back on.

And don’t forget to bookmark the Veritas Dental Resources Blog—it’s where insurance weirdness gets translated into strategies that actually work.

Appeal Like a Pro

Just because a claim is denied doesn’t mean it’s dead. Fight back with supporting documentation, narratives, and all the firepower you can muster. Appeal, appeal, appeal.

Final Thought: You Deserve to Be Paid for Your Work

You’re not a volunteer. You didn’t go to dental school to spend your life begging for permission to treat patients or asking insurance companies for their blessing.

You are a highly trained, deeply skilled healthcare professional—and you deserve to be paid accordingly.

The CDT system may be flawed, and insurance companies may keep playing the "deny everything new" game. But with the right knowledge, the right partners, and the courage to say “no more,” you can rise above it.

Stop letting a third party determine the value of your work.

You didn’t go into dentistry to be someone else’s spreadsheet line item.

You went into dentistry to change lives.

So bill like it. Appeal like it. Train your team like it. And never forget it.

Need help navigating the chaos?
Visit www.veritasdentalresources.com for strategies, training, and the occasional sarcastic blog post that’ll make you laugh while teaching you how to fight back—and win.

Benjamin Tuinei

Founder - Veritas Dental Resources, LLC
Phone: 888-808-4513

Services:
PPO Fee Negotiators | PPO Fee Negotiating | Insurance Fee Negotiating
Insurance Credentialing | Insurance Verifications

Websites:
www.VeritasDentalResources.com | www.VerusDental.com