Canadian Dental Procedure Codes: A Comprehensive Guide - Insurdinary (2022)

From quadrants to tooth numbers, dentistry has its own mysterious language.

Industry-specific language helps dentists do their job. But when it comes to your teeth, you want to understand what's going on — especially when it's time to pay for your dental work.

Canada's universal health care system doesn't cover most dental procedures. Canadians pay for dentistry out of pocket or through private insurance.

But the truth is thatit's hard to find a Canadian plan that covers all dental costs. That means that after a trip to the dentist,you'll be paying for at least part of your dental bill out of your own pocket. And that means that you'll want to know exactly what the dentist is charging you for.

If you want to learn to speak the lingo of Canadian dental procedure codes, this guide is for you. Keep reading to learn what Canadian dental codes mean and how they differ among provinces. Most importantly, we'll explain why they matter for your dental insurance claims, and how you can avoid overpaying for dental fees.

Jump To:

  • What Are Canadian Dental Procedure Codes?
  • Canadian Dental Code Categories
  • Why Are Dental Codes Important?
  • How Can I Avoid Overpaying?

What Are Canadian Dental Procedure Codes?

The Canadian dental procedure codes are a system of categorizing dental services. Different countries use different systems to standardize their dental procedures. The Canadian dental industry uses this unique system to keep its services consistent across the country.

The Canadian Dental Association (CDA) develops and regulates this system. Every dental service has a unique 5-digit number. Canadian dentists use these codes to record their services, communicate within the industry, and bill clients.

This coding system gives structure to the Canadian dental industry. Without a standardized system, Canadian dentists wouldn't know exactly how to define or charge the work they do. It allows Canadian dentists to standardize their work.

It also allows governing bodies to regulate how dentistry is performed, and how much dentists charge for each service. Finally, it lets insurance companies decide how much of the cost of dental procedures they will cover.

The Canadian Dental Procedure codes are recognized across Canada. Each province uses slightly different codes, though they are similar enough for Canadian dentists and insurance companies to use consistently. However, Quebec uses a significantly different coding system.

Canadian Dental Code Categories

Let's take a look at the nitty-gritty of dental procedure codes.

There are over 1,300 unique codes (plus, the Canadian Dental Association introduces new codes all the time as new dental procedures emerge). There are also specialized sets of codes for dental hygienists, as well as dental specialists. That's a lot of numbers.

But don't worry: There's no need to get familiar with every single code. The Canadian Dental Association breaks down dental services into 10 basic categories. Each 5-digit code fits into one of these categories.

Diagnostic Services

Codes 00001-09999 refer to all dental services that diagnose diseases and problems. Dental exams start from 01011, which refers to dental exams for children up to 3 years old. They increase in price and complexity to in-depth exams for maxillofacial and dental problems.

This range also includes tests, X-rays and other photography,professional consultations, and making models of teeth such as dental casts.

Preventative Services

Codes 10000-19999 include services that prevent dental disease and maintain oral health. Since these tend to be the most common reasons Canadians visit the dentist, you'll see this range of codes most frequently.

In this range, you'll see regular services such as cleaning, fluoride treatment, polishing, and scaling. Less common services like oral appliances and nighttime retainers fall into this category as well.

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Restorative Services

Codes 20000-29999 include services that restore your teeth after damage. They may include tooth crowns (whether applying them or removing them to re-apply), and tooth fillings.

Tooth fillings have many different components, from the pin that holds the filling to the tooth's root to the visible core and crown. Each of these services has a unique code and can be billed separately.

Endodontic Services

Codes 30000-39999 relate to procedures that treat the live part of your tooth (including the nerve and pulp) rather than the bony enamel.

Root canals (removing the soft tissue and nerve from inside a tooth when it becomes infected) are the most well-known procedure from this service range. Children who still have their primary teeth can also suffer from pulp infection. In their case, they will have a pulpectomy (removing the soft tissue without the nerve) to keep the infection from spreading.

Periodontal Services

Codes 40000-49999 deal with corrective procedures to the gum and periodontium.

In periodontal disease, bacteria infect your gums and cause them to pull away from your teeth. To correct this problem, you may need periodontal services like in-depthteeth scaling and root planing.

Removable Prosthetics

Codes 50000-59999 account for insertion, removal, maintenance, and repair of removable dentures.

Dentures can be costly. Remember that these codes only account for the service costs for denture maintenance. The actual costs of dental prosthetics, such as partial or full dentures, aren't included.

Fixed Prosthodontic Services

Codes 60000-69999 include non-removable dentures and other permanent appliances. Services such as inserting, maintaining, and removing semi-permanent permanent retainers fall into this category.

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Oral and Maxillofacial Surgical Services

Codes 7000-79999 refer to reconstructive surgeries of the mouth and jaw. These may include inserting dental implants into the bone, reconstructive jaw surgery, and dental extractions (pulling a tooth). It can also include soft tissue surgeries such as biopsies and surgical gum reconstruction.

Orthodontic Services

Codes 80000-89999 include dental services that adjust tooth spacing without surgery, especially inserting, adjusting, and removing braces. This includes traditional wire braces, as well as newer appliance types such as aligners and spacers.

Adjunctive General Services

Finally, codes 90000-99999 refer to miscellaneous services not covered by other categories. They can range as widely as court appearances to botox administration, as well as general anesthesia for dental surgery, tooth whitening, and professional consulting.

Single and Multiple Units

The last digit in a code often refers to how many units of that service you received. For instance, the dental code 11111 refers to 1 unit of scaling (scraping plaque buildup from your teeth).

A "unit" of scaling means the amount of scaling that the dental hygienist did in 15 minutes. If it took 30 minutes to scale your teeth, you would be charged for 2 units of scaling instead. The code for 2 units of scaling is 11112; the code for 3 units is 11113, and so on.

Why Are Dental Codes Important?

To your dentist, Canadian dental procedure codes are professionally useful. They standardize their work and make it possible to bill efficiently.

But to you, they're important because they determine how much you pay for your dental work.

As Canadians know, there are some excellent full-coverage insurance plansout there that will cover your dental costs. However, insurance usually covers most, not all, dental expenses. That means even if you have insurance, you'll likely pay some dental costs out of pocket.

But how much will you pay? Canadian dental procedure codes have the answer.

Dental Codes and Insurance

When you look at the invoice your dentist's office issues, you'll see the services you received along with their 5-digit dental procedure code.

For instance, you'll see something like:

  • 11111: 1 unit of scaling
  • 02112: 2 radiographic images

They'll be listed along with the amount that the dentist is charging you for each service.

Many insurance plans cover a fixed amount for each standardized service. Most commonly, they cover the amount that your province suggests that those standardized services are worth. That amount is determined by your province's dental fee guide.

Provincial Fee Guides

Every Canadian province and territory has its own Dental Association, and each provincial association issues a fee guide for the dentists who work inthat province. This is a guide that states how much a dental procedure is worth under normal conditions, and sets the norm for the prices that all provincial dentists use.

By listing every standardized dental procedure by its code number, the fee guide suggests how much each dentist should charge for those procedures.

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Dental Fees Vary

While your province's dental association issues a suggested fee amount for every service in the Canadian dental procedure code, the final amount that you pay for a service is up to your dentist.

Dental practices are private businesses. That means they are free to charge as much or as little for their services as they choose.

For example, if your provincial fee guide suggests charging a $45 fee for a service, your dentist may charge $40, $50, or whatever they choose.

But your insurance provider usually only covers the suggested fee for a dental procedure. In the example above, your insurance may cover the suggested fee of $45. If your dentist charges $50, you will end up paying the difference out of pocket.

Of course, dental procedures can be much more costly than this example. Braces, prostheses, and surgeries can cost hundreds or even thousands of dollars, and the difference between the suggested cost and your dentist's actual cost can be proportionally larger. That means you can end up paying a surprising amount for your dental work.

How Can I Avoid Overpaying?

Being able to interpret your dental codes helps you understand the world of dental lingo. But with so many Canadians avoiding costly dental work, can it help you avoid overpaying for dental procedures?

The Canadian Dental Association doesn't publish its updated national fee guide to the general public. Since the fee guideline is costly to write and maintain, dentists must purchase access to it to cover its production costs. Some provinces make their fee guide publically available, but they caution that it is so technical that it can be hard for those outside the industry to read.

We don't know exactly what fees the Canadian Dental Association suggests to its members. But that doesn't mean you can't find lower prices for coded dental procedures.

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Choose Your Dentist

If your insurance only covers the suggested fee, you don't necessarily have to pay out of pocket. Instead, compare the prices of different dentists in your area.

You might not be able to know exactly which dentists are sticking to the suggested dental fees. However, you may still find a range of prices.

Some dentists choose to keep their fees at or under the suggested cost to stay competitive in the dental market. Others charge more than the suggested cost, whether to offset their own fees or for other reasons. While you won't know exactly which fees are within the suggested range— the range that your insurance is more likely to cover— you can still find the lowest cost and avoid higher out-of-pocket costs.

Choose Your Insurance

While 32% of Canadians still don't have dental insurance, there's no doubt that in Canada, having dental insurance coverage is a must. But there are tons of options to choose from, and the plan you pick will significantly impact what you finally end up paying.

If you're worried about paying unexpected out-of-pocket costs at the dentist, look for a plan that has high monthly coverage. A bargain plan costs less upfront, but may not fully cover your costs. Especially if you expect to have dental expenses in the future, such as aligners, choose a plan that will defray your costs.

Canadian Dental Procedure Codes: A Comprehensive Guide - Insurdinary (4)Canadian Dental Procedure Codes: A Comprehensive Guide - Insurdinary (5)

Canadian Dental Procedure Codes: A Comprehensive Guide - Insurdinary (6)

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Canadian Dental Procedure Codes, Explained

Canadian dental procedure codes are the basis for dental costs and coverage. They're the key to understanding your dental expenses and insurance. With this guide, you'll be able to understandyour dental procedure codes and take ownership of your dental costs.

With so many dental options, choosing an insurance plan can be overwhelming. Insurdinary compares the most comprehensive health and dental insurance quotes so that you can find the Canadian dental plan that meets your needs.

Best of all, Insurdinary finds the best monthly rates in Canada, so you know that you're not overpaying for your insurance.If you're looking for affordable dental insurance in Canada, get started with Insurdinary today.

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FAQs

Are dental codes the same across Canada? ›

each dental procedure is identified by a "dental code," which is a 5-digit number. dental procedure codes are the same throughout Canada!

What is the dental code for comprehensive exam? ›

Comprehensive Oral Evaluation, new or established patient: This code applies when a general dentist and/or dental specialist examines the patient.

What is dental procedure code 11112? ›

The second important code allows you to have your cleaning done more than once or twice a year, this is the scaling code — code 11112,11113, or 11114. Each insurance company will allot a certain number of scaling units.

What is dental Code D7280? ›

D7280 – Surgical access of an unerupted tooth

This procedure includes an incision, the reflection of tissue, and the removal of bone as necessary to expose the crown of an impacted tooth not intended to be extracted.

What is the difference between CDT and CPT codes? ›

Consider type of coverage – dental or medical: A major factor governing CDT vs. CPT code use is the type of coverage that the patient has. To assign a CDT dental code on the claim for a dental procedure, the patient must have dental insurance.

Are dental codes universal? ›

The best thing about ADA dental codes is that they're universal. All dentists who belong to the ADA use D0210 to represent a complete series of radiographic images.

What is a comprehensive code? ›

1 of broad scope or content; including all or much. 2 (of a car insurance policy) providing protection against most risks, including third-party liability, fire, theft, and damage. 3 having the ability to understand.

What are dental comprehensive services? ›

Most Comprehensive Dental Care Includes:

Teeth Cleanings & Exams. Dental Sealants & Fillings. Mouthguards. Crowns & Bridges.

What is the CPT code for comprehensive history and exam? ›

New Patient Office Visit (CPT Codes 99201-99205): Coverage and Documentation Requirements
CPT CodeDescription
99205Typically 60 minutes Comprehensive history Comprehensive Examination High complexity medical decision making
4 more rows
7 Feb 2018

What is dental code D2392? ›

D2392 Resin-based composite - two surfaces, posterior.

What is dental code D3428? ›

Codes. 1,2. D3428 – Bone graft in conjunction with periradicular surgery-per tooth, single site. D3429 – Bone graft in conjunction with periradicular surgery-each additional contiguous tooth in the same surgical site.

What is dental code d9410? ›

Includes visits to nursing homes, long-term care facilities, hospice sites, institutions, etc. Report in addition to reporting appropriate code numbers for actual services performed. service.

What is dental code D5282? ›

D5282. Removable unilateral partial denture – one piece cast metal (including retentive/clasping materials, rests, and teeth), maxillary.

What is dental code D6056? ›

D6056: Prefabricated abutment — includes modification and placement.

What is dental code D8090? ›

D8090—Comprehensive orthodontic treatment of the adult dentition. This code is commonly used for adults who are undergoing occlusion and alignment corrections.

What is the difference between CDT and non CDT? ›

CDT stands for “Cannabis-Derived Terpenes.”

Delta 8 THC cartridges contain a delta 8 THC distillate that produces the desired effects of tetrahydrocannabinol when inhaled. When this distillate is the only extract present in the cart, they're known as non-CDT cartridges.

Can dentists use CPT codes? ›

Dentists using CPT procedure codes and coding must select the code for the procedure or service which most accurately identifies the service performed. Any additional procedures performed, or pertinent special services, must also be listed.

How many dental procedure codes are there? ›

Updated annually on 10/1. Approximately 66,000 codes.

What is a procedure code Canada Life? ›

The Canadian dental procedure codes are a system of categorizing dental services. Different countries use different systems to standardize their dental procedures. The Canadian dental industry uses this unique system to keep its services consistent across the country.

Do dentists have to use ICD 10 codes? ›

Dentists, by virtue of their clinical education, experience and professional ethics, are the individuals responsible for diagnosis. As such, a dentist is also obligated to select the appropriate diagnosis code for patient records and claim submission.

What are the 3 types of codes? ›

The Three Types of Code
  • Boring Code. Boring code is when it makes perfect sense when you read it. ...
  • Salt Mine Code. This is the type of code that's bonkers and makes not a lick of sense. ...
  • Radioactive Code. Radioactive code is the real problem at the heart of every engineering team.
3 Feb 2020

What are the four types of codes? ›

There are four types of coding:
  • Data compression (or source coding)
  • Error control (or channel coding)
  • Cryptographic coding.
  • Line coding.

Where can I look up CPT codes? ›

The Centers for Medicare & Medicaid Services offer a free search (CPT code lookup) for RVU for every CPT code. Users can also request a CPT/RVU Data File license from the AMA to easily import codes and descriptions into existing claims and medical billing systems.

What are the three classifications of dental services? ›

Dental insurance plans often describe dental services in three classes of service: Class 1: Preventative and diagnostic care, such as x-rays and cleanings. Class 2: Basic restorative care, including fillings and root canals. Class 3: Major restorative care, including dentures, bridges, and crowns.

What are the components of a comprehensive dentistry program? ›

Students who participate in the Comprehensive Dentistry program will perform all phases of dentistry on a post-graduate level. Phases include, but are not limited to, crown and bridge, implant supported prosthesis, root canal therapy, partial and full dentures, porcelain onlays and inlays and porcelain laminates.

What dental procedures are considered preventive? ›

Preventive dental services include oral exam, teeth cleaning, and routine X-rays. There are often limits on how many you can get each year. If you go over those limits, you may have to pay out-of-pocket, so it's important you understand the details of your coverage.

What does a comprehensive exam cover? ›

In an individual course, a comprehensive exam is usually the final exam/test for the course and covers all material from the entire course. In a degree, a comprehensive exam is part of finishing the degree. It draws on the student's learning throughout the degree program and can be written, oral or both.

What are the 4 examination levels? ›

Similar to the levels of history, there are four levels of physical exam documentation:
  • Problem Focused.
  • Expanded Problem Focused.
  • Detailed.
  • Comprehensive.

What CPT code is 78306? ›

CPT® Code 78306 - Diagnostic Nuclear Medicine Procedures on the Musculoskeletal System - Codify by AAPC.

What is dental code D3220? ›

D3220. Therapeutic pulpotomy (excluding final restoration) – removal of pulp coronal to the dentinocemental. junction and application of medicament.

What is dental code D6240? ›

D6240 Pontic, porcelain fused to precious/high noble metal. (bridge units)

What is dental code D3331? ›

Two CDT codes that we discussed in particular were D3331 (treatment of root canal obstruction) and D2955 (post removal).

What is dental code D0367? ›

D0367. Cone beam CT capture and interpretation with field of view of both jaws; with or without cranium. D0368. Cone beam CT capture and interpretation for TMJ series including two or more exposures.

What is dental code D9221? ›

D9221. Deep sedation/general anesthesia – each additional 15 minutes. D9241. Intravenous moderate conscious sedation/analgesia – first 30 minutes.

What is dental code D4263? ›

Diagnosis: Severe periodontal bone loss Treatment: D4263 bone replacement graft - retained natural tooth - first site in quadrant and D4266 guided tissue regeneration - resorbable barrier per site.

What is dental code D2940? ›

D2940 protective restoration—Direct placement of a restorative material to protect tooth and/or tissue form. This procedure may be used to relieve pain, promote healing, and prevent further deterioration. Not to be used for endodontic access closure, and as a base liner under restoration.

What is dental code D7922? ›

D7922 placement of intra-socket biological dressing to aid in hemostasis or clot stabilization, per site.

What is dental code D1203? ›

Rating: +1. The difference is quite simple CDT code D1203 Topical Fluroide is used for children who are not at a high risk of developing caries. While CDT code D1206 was created for patients who are at moderate to high risk of developing caries due to systemic disease, medications they are taking or other conditions.

What is dental code D2930? ›

D2930 Prefabricated stainless steel crown - primary tooth Yes* Tooth designation required.

What is dental code D5120? ›

□ D5120 Complete Denture - Mandibular.

What is dental code D7282? ›

D7282 mobilization of erupted or malpositioned tooth to aid eruption To move/luxate teeth to eliminate ankyolosis; not in conjunction with an extraction.

What is dental code D6054? ›

D6054. Implant/abutment. supported removable denture for. partially edentulous arch. D6055 Dental implant supported connecting bar A device attached to transmucosal abutments to stabilize and anchor a removable over denture prosthesis.

What is dental code D8999? ›

D8999 Unspecified orthodontic procedure, by report – Used for procedure that is not adequately described by a code.

What is dental code D6115? ›

The final All-on-Four prosthesis can be reported using code D6114/D6115 for the fixed complete denture prosthesis for each arch restored. This is commonly referred to as a “hybrid prosthesis.”

What is dental code D8020? ›

D8020. Limited orthodontic treatment of the transitional dentition.

What is dental code D0470? ›

According to the ADA D0470 diagnostic casts are billable anytime diagnostic aides are needed or required for the treatment of specific procedures (i.e. orthodontia, TMJ disorders, Orthognathic Surgery, etc.). This code would be inappropriate for impressions and bite registration if diagnostic casts are not created.

What is dental code D2150? ›

D2150. Amalgam – Two Surfaces, Primary or Permanent.

Which tooth numbering system is used in Canada? ›

The most commonly used system is the Fédération Dentaire Internationale (FDI) system and this is the one used in Quebec, in Canada and in most European countries. Each tooth is represented by a 2-digit number.

What is dental cross coding? ›

For certain procedures, dental offices are required to bill a patient's medical plan for dental procedures that are typically considered “medical” in nature. The submission of dental treatments to medical payers – referred to as dental to medical cross-coding – can seem complex.

What are the 3 different tooth numbering systems? ›

The three most common systems are the FDI World Dental Federation notation (ISO 3950), the Universal Numbering System, and the Palmer notation. The FDI notation is used worldwide, and the Universal is used widely in the United States. The FDI notation can be easily adapted to computerized charting.

Is dentistry regulated in Canada? ›

Dentistry is a regulated profession in Canada. Each provincial dental regulatory authority is responsible for establishing the licensure requirements in their province.

How do Canadian dentists number teeth? ›

Palmer Notation Method

In this system, the mouth is divided into four sections called quadrants. The numbers 1 through 8 and a unique symbol are used to identify the teeth in each quadrant. The numbering runs from the center of the mouth to the back.

What numbering system do dentists use? ›

Universal method – starting at the rear right upper molar and preceding to the rear left upper molar, teeth are numbered 1 to 16. Then, the bottom teeth are numbered from left to right 17 to 32. This numbering system allows for all 32 teeth, including wisdom teeth, to be present.

How many dental procedure codes are there? ›

Updated annually on 10/1. Approximately 66,000 codes.

Is dental coding the same as medical coding? ›

Differences Between Dental and Medical Billing

Medical coding depends on three aspects: CPT, HCPCS, and ICD-10. Dental coding utilizes a significant text known as Current Dental Terminology and issued by the American Dental Association. So, the inclusion of codes is different in both medical billing procedures.

What is the dental code 4342? ›

D4342 periodontal scaling and root planing One to three teeth per quadrant Definition: A therapeutic procedure involving instrumentation of the crown and root surfaces of the teeth designed to remove plaque and calculus, as well as remove cementum and dentin that is rough, and/or permeated by calculus or contaminated ...

What are the 8 different tooth classifications? ›

Types of teeth
  • Incisors. The eight teeth in front are called the incisors. ...
  • Premolars. Also called bicuspids, premolars chew and tear food. ...
  • Molars. The most posterior teeth in the mouth are called molars. ...
  • Canines. The next set of teeth are called canines. ...
  • Supernumerary teeth.
3 Dec 2018

What are the 4 dental quadrants? ›

The right upper part of your mouth is the first quadrant, followed by the top left side (second quadrant). The bottom of your mouth has the opposite designation. The left bottom side is the third quadrant, and the right bottom side is the fourth quadrant.

What is tooth number 4 called? ›

Number 4: 2nd Bicuspid also known as 2nd premolar. Number 5: 1st Bicuspid or 1st premolar. Number 6: Cuspid or canine. Number 7: Lateral incisor (upper right)

What is the average salary for a dentist in Canada? ›

Find out what the average Dentist salary is

The average dentist salary in Canada is $128,915 per year or $66.11 per hour. Entry-level positions start at $115,000 per year, while most experienced workers make up to $232,538 per year.

Who regulates dentistry in Canada? ›

The ODQ is the professional order responsible for overseeing the practice of dentistry in Quebec, and whose main purpose is to protect the public. Dental school graduates from outside Quebec who wish to practise here must: obtain recognition of their diploma and training equivalence.

Who regulates dentists in Canada? ›

Healthcare professionals, including dentists, fall under the authority of the provinces. Healthcare in Canada is governed at a federal level under the Canada Health Act (CHA).

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