New ADA guide covers CDT codes for saliva tests

Testing offers noninvasive alternative for detecting oral health biomarkers

A new guide from the American Dental Association outlines the appropriate CDT codes to use when collecting and analyzing saliva samples for diagnostic purposes.

“Saliva is proving to be a simple yet powerful source for detecting infections and monitoring oral health biomarkers, offering a versatile diagnostic and educational tool to advance health care insights,” said Mark A. Moats, D.M.D., chair of the ADA Council on Dental Benefit Programs. “As salivary diagnostics and screenings continue to evolve, dental professionals should stay informed about appropriate procedural coding to ensure accurate documentation and reporting.”

Saliva-based diagnostic testing is typically conducted in certified laboratories following Clinical Laboratory Improvement Amendments standards to assess a patient’s condition and aid in treatment planning. At this time, no salivary diagnostic tests have been approved by the U.S. Food and Drug Administration for assessing the risk of periodontal disease, dental caries, or head and neck cancer.

In the CDT Code, saliva-based diagnostic procedures are categorized based on the type of test performed, the purpose of the sample collection and the nature of the analysis. Below are the codes for laboratory-based saliva diagnostic testing:

• D0417 collection and preparation of saliva sample for laboratory diagnostic testing. 
• D0418 analysis of saliva sample: This code is for the chemical or biological analysis of a saliva sample for diagnostic purposes.
• D0419 assessment of salivary flow by measurement: This procedure identifies low salivary flow in patients at risk for hyposalivation and xerostomia, as well as the effectiveness of pharmacological agents used to stimulate saliva production.

Recently, saliva screening that can be conducted in the office or at home to monitor wellness has seen an increase in adoption. This differs from laboratory-based saliva diagnostic testing in both its application and coding requirements.

For example, dental practices would use codes D0417 for sample collection and D0418 for sample analysis if they carefully collect patient samples and send them to a certified laboratory where advanced technologies are used to create a diagnostic report.

However, if a dental practice uses a screening tool that allows the patient to collect a saliva sample on a test card and use a mobile app to receive instant results, it would use code D9999 unspecified adjunctive procedure, by report, and include detailed documentation to describe the test. This is because the test is meant for educational purposes only and is not intended to diagnose or treat disease.

Dentists can find the coding guide for salivary diagnostics at ADA.org. Members of the ADA Council on Dental Benefit Programs serve as the editorial panel on CDT Code guidance documents and educational resources.