What Dental Coders Need to Know About Saliva Testing
Published by the American Dental Coders Association
Saliva testing is an emerging tool in modern dentistry, providing valuable insights into oral and systemic health. As these tests become more widely adopted in dental practices, dental coders must be prepared to navigate the evolving coding and billing landscape.
This article will explore the key points dental coders need to understand about saliva testing — including its clinical relevance, applicable CDT and diagnostic codes, billing challenges, and documentation requirements.
What Is Saliva Testing in Dentistry?
Saliva testing involves the collection and laboratory analysis of a patient’s saliva to detect markers related to oral bacteria, genetic susceptibility, viral infections, and systemic conditions. It is especially useful for:
- Periodontal disease risk assessment
- HPV screening
- Inflammation and immune response markers
- Oral microbiome profiling
- Genetic predispositions to caries or periodontitis
Why It Matters to Dental Coders
Saliva testing services are often outsourced to third-party labs and are not always covered under standard dental insurance policies. However, they may be medically necessary in specific circumstances and eligible for reimbursement through either dental or medical insurance.
Dental coders must be able to:
- Recognize when saliva testing is clinically justified
- Use correct CDT and/or HCPCS codes
- Document procedures appropriately for payer review
- Understand medical cross-coding when needed
Is There a CDT Code for Saliva Testing?
Currently, no specific CDT code is dedicated solely to saliva testing. However, in some situations, practices may report the procedure using:
- D0999 – Unspecified diagnostic procedure, by report
This code requires:
- A detailed narrative describing the reason for the test
- A description of the specimen collection process
- A report of findings and how they influence treatment
Medical Cross-Coding for Saliva Testing
When saliva testing is related to systemic conditions (e.g., HPV screening, inflammation markers), billing through medical insurance may be more appropriate.
Dental coders should be familiar with:
- CPT codes like 87624 (HPV detection), 81479 (unlisted molecular pathology)
- ICD-10 codes such as K05.6 (periodontal disease), Z13.850 (screening for oral diseases)
Be sure to include diagnosis codes that justify medical necessity and proper documentation.
Documentation Best Practices
To support saliva testing claims, document the following:
- Patient history and risk factors
- Clinical justification for testing
- Test type and date collected
- Lab used and turnaround time
- How test results influence diagnosis or treatment plan
Billing Challenges and Tips
Common Challenges:
- Limited coverage under dental insurance
- D0999 requires manual review and detailed narratives
- Unclear boundaries between medical and dental billing
Tips for Success:
- Always verify coverage before administering the test
- Submit supporting documentation proactively
- Educate providers on how to document medical necessity
- Stay up-to-date with payer policy changes and CDT updates
The Future of Saliva Testing in Dentistry
Saliva testing is expected to play a growing role in preventive and diagnostic dentistry. As testing methods become more refined and widely adopted, dental coding will likely see future updates to include new codes or revised guidance.
The American Dental Coders Association is committed to helping dental professionals stay current as the industry evolves. Look to us for training, certification, and ongoing support in advanced topics like diagnostics and cross-coding.
Get Certified and Stay Ahead
To stay competitive and confident in your dental coding role, consider these certification paths through ADCA:
- Certified Dental Coder (CDC)
- Certified Dental Billing Specialist (CDBS)
- Dual Certification Program
- CDBS Exam
- CDC Exam
Conclusion
As dental technology evolves, coding professionals must adapt quickly. Saliva testing may not be standard in every practice yet, but its use is growing — and so is the need for accurate documentation and coding.
By staying informed and certified, you’ll be ready to meet the demands of tomorrow’s dental billing landscape. Stay connected with the American Dental Coders Association for the latest in coding education and support.
