Unlisted Procedure or Service
Dental
Policy Number: DP-X-007
Last Updated: Sept. 15, 2022
Unlisted procedure codes have been designated to report services or procedures that are not found in the CPT or CDT manual.
Any procedure not accurately described in CDT should be reported using the appropriate unspecified (D9999) code with a narrative description by report.
When an unlisted procedure code is submitted, the claim cannot be reviewed without a description of the service. Documentation, such as visit or operative notes clearly detailing the service provided, should be submitted with the claim.