According to a 2026 report by Zentist, 78% of dental practices surveyed reported an increase in insurance claim denials or payer scrutiny over the previous 12 months. While not all claim denials are caused by coding errors, using the wrong procedure code can create additional complications for your billing staff, especially when they have to correct and resubmit claims.
However, dental practices don’t always deal exclusively with dental insurance. For instance, a patient who suffers facial injuries following an accident may require procedures that qualify for medical insurance coverage. While both medical and dental claims involve reporting the treatments provided, the coding requirements aren’t necessarily the same.
So, what is the difference between CPT and CDT codes? More importantly, how do you determine which coding system your practice should use when preparing insurance claims?
What Are CPT Codes?
Developed and maintained by the American Medical Association (AMA), Current Procedural Terminology (CPT) is a coding system that is used to describe medical procedures and services that doctors and other qualified healthcare professionals do for patients.
CPT codes often consist of five numbers, although some follow an alphanumeric format. These codes standardize how doctors report the services they’ve performed when submitting medical insurance claims.
For example, a patient suffers an accident that affects their jaw and needs medical treatment. In most cases, the necessary procedures will have a corresponding code that doctors can use to represent them when submitting claims to the patient’s insurance provider.
What Are CDT Codes?
On the other hand, Current Dental Terminology (CDT) is much like CPT codes but is maintained by the American Dental Association (ADA) specifically for dental services. CDT codes represent a wide range of dental interventions, from examinations and preventive treatments to restorations and oral surgery. When a patient receives dental treatment, CDT codes are used to report the procedures when filing dental insurance claims.
Similar to CPT codes, CDT codes are updated annually, with some codes updated or replaced entirely. This means that you or your staff must stay on top of these changes by referring to an updated code master list if reducing claim rejections and improving your revenue cycle are top priorities.
CPT vs. CDT Codes: What Are the Main Differences?
When comparing CPT vs. CDT codes, the main distinction is the type of healthcare services each coding system is intended to describe. While both are used to report procedures performed on patients, they differ in their format, the organizations responsible for maintaining them, and how they’re commonly used for insurance billing.
For instance, CPT codes are maintained by the American Medical Association and generally consist of five characters, with most codes using a numeric format. On the other hand, CDT codes are maintained by the American Dental Association and follow a different format, beginning with the letter D followed by four numbers.
Another difference is how they’re commonly used when submitting insurance claims. CPT codes are primarily associated with medical insurance, while CDT codes are generally used when reporting procedures to dental insurance providers.
| Area of Comparison | CPT Codes | CDT Codes |
| Full name | Current Procedural Terminology | Current Dental Terminology |
| Maintained by | American Medical Association (AMA) | American Dental Association (ADA) |
| Primary purpose | Reporting medical procedures and services | Reporting dental procedures and services |
| Code format | Generally five characters, typically numeric | Letter D followed by four numbers |
| Commonly used for | Medical insurance claims | Dental insurance claims |
| Updated | Annually | Annually |
However, these CPT and CDT differences don’t mean that dental practices can only use CDT codes or that CPT codes are exclusive to physicians. Depending on the procedures performed and the insurance coverage involved, your practice may encounter situations where both coding systems are relevant.
When Should Your Dental Practice Use CPT or CDT Codes?
For most routine dental treatments, your practice will generally use CDT codes when documenting procedures and submitting claims to dental insurance providers. However, there may be instances where a patient’s condition requires treatment that also falls under medical insurance coverage.
For instance, a patient who suffers a fractured jaw may require oral surgery as part of their treatment. Depending on the procedure performed and their insurance benefits, your billing staff may need to prepare a medical claim using the appropriate CPT codes and diagnosis codes.
However, not every procedure involving the mouth or jaw automatically qualifies for medical insurance coverage. Before submitting a claim, your staff needs to verify the patient’s benefits and the payer’s coding requirements to determine how the treatment should be reported.
Why Is Understanding CPT and CDT Differences Important?
Using the wrong procedure code can lead to claim rejections or denials, which means your billing staff may have to correct the information and submit the claim again. Apart from delaying reimbursement, these additional responsibilities can take up time that your administrative team could otherwise spend attending to patients.
This is why understanding the differences between CPT and CDT codes is important, especially if your practice handles procedures that may involve both medical and dental insurance. While dental virtual assistants (VAs) can help with responsibilities such as insurance verification and claims follow-up, your practice still needs appropriate coding review procedures to make sure the information being submitted is accurate.
Make Managing Your Dental Practice Easier
Running a dental practice involves administrative responsibilities that don’t necessarily require the attention of your clinical staff. Apart from preparing insurance claims, your team also needs to verify patient benefits, monitor outstanding payments, and communicate with insurance payers whenever additional information is required.
If you’re considering hiring additional administrative support, My Mountain Mover can help you find a dental virtual assistant (VA) with experience handling the responsibilities you want to delegate. Book a 10-minute discovery call today to learn more.
Frequently Asked Questions
Can Dental Practices Use Both CPT and CDT Codes?
Yes. Depending on the procedures your practice performs and the patient’s insurance coverage, you may encounter situations where both coding systems are relevant. However, this doesn’t necessarily mean that a procedure can be reported using either code because the appropriate coding requirements will depend on the service and the payer.
Are CPT and CDT Codes Interchangeable?
No. Although some medical and dental procedures may involve similar treatments, CPT and CDT codes belong to separate coding systems and don’t necessarily have direct equivalents. Your billing staff should verify the appropriate code rather than substituting one for the other when preparing insurance claims.
How Often Are CPT and CDT Codes Updated?
Both coding systems are updated annually by their respective organizations, with the AMA responsible for CPT and the ADA responsible for CDT. Since these updates may introduce new codes or revise existing descriptions, your practice should refer to the current editions when documenting procedures and submitting claims.
