The ADA has confirmed 67 changes for CDT 2027. Before anyone pictures 67 brand-new codes marching into the office at once, let’s clear that up.
The total includes 28 additions, 33 revisions and six editorial changes. There are no deletions. The 2027 code set is effective January 1 through December 31, 2027.
That means the practical job is not memorizing a dramatic number. It is identifying which changes affect the procedures your practice actually performs, updating the right systems and helping the clinical and billing teams use the same language. Preferably before the first claim of January is sitting in a rejection queue asking why everyone ignored it.
This article is a preparation guide, not a replacement for the complete CDT 2027 manual. The full nomenclature and descriptors matter when a dentist selects the code that accurately documents the service delivered. A summary can point you toward the right drawer. It cannot tell you everything inside it.
The changes practice teams are most likely to notice
The ADA’s published highlights group several of the updates into practical themes:
- Implant and prosthetic work: New reporting options include the removal of a screw-retained indirect restoration so the implant body can be treated, placement of a healing cap and implant- or abutment-retained interim fixed dentures for a partially edentulous arch. The ADA also highlights additions and revisions involving semi-precision abutments and attachments.
- Restorative treatment: The revision to D2390 allows a direct resin-based composite crown to document treatment delivered to an anterior or posterior tooth. The prior nomenclature specified anterior teeth.
- Adjunctive orthodontic therapy: The section previously titled “Minor Treatments to Control Harmful Habits” is revised, including changes involving D8210 and D8220.
- Orofacial pain management: The update adds reporting options for several injection blocks and for tendon, ligament and trigger-point muscle injections. It also distinguishes cosmetic and therapeutic chemodenervation procedures more clearly.
- Fixed splints: New codes address repair and removal.
If your practice does not perform a particular procedure, that section may not require a training seminar and matching commemorative tote bag. Focus your review on the work your clinicians deliver and the codes your team uses.
A new or revised code is not a coverage promise
CDT codes document and report procedures. They do not decide whether a patient’s plan covers those procedures.
The ADA states this directly: the existence of a procedure code does not mean the service is a covered or reimbursed benefit. Coverage limitations, exclusions and participating-provider agreements still matter. So do the payer’s current documentation and claim-submission rules.
In plain language: use the code that accurately describes what was done, then evaluate the benefit and contract separately. Choosing a code because it appears more likely to pay is not a coding strategy. It is a future follow-up project wearing a nice outfit.
Your software will not do the thinking for you
For Open Dental practices, the current manual says Procedure Code Tools are used to update ADA CDT codes each calendar year. New CDT codes are generally released through Open Dental version updates at the beginning of the appropriate year.
Open Dental also warns users to be careful when running those tools. Some options can reset customized Auto Codes, Procedure Buttons, appointment quick-add procedures or recall types. Updating missing D codes is not the same thing as checking every box and hoping for a productive surprise.
The documented Open Dental workflow requires the appropriate Security Admin and Procedure Code Edit permissions. The software’s procedure-code screen also handles fee schedules separately. After the 2027 codes are available for your supported version, the responsible administrator should review the official release guidance, make a backup according to the practice’s normal process, choose only the tools intended for the update and confirm the results.
If your practice uses another platform, follow that vendor’s official annual-code-update instructions. The button may move. The responsibility to review what changed does not.
A five-part CDT 2027 preparation plan
- Start with the official code set. Use the ADA’s current CDT 2027 materials for complete nomenclature and descriptors. Avoid building office policy from a social-media screenshot or a partial payer summary.
- Identify your affected workflows. Review the services your clinicians actually provide, especially implant, prosthetic, restorative, orthodontic and orofacial-pain procedures highlighted in the 2027 update. Map each affected service from clinical notes through claim submission.
- Update codes and review fees separately. Confirm that the correct 2027 codes are available in your software for dates of service beginning January 1. Then review your practice fee schedules and treatment-plan workflows. A code-set update does not establish your fees, and the ADA does not set fee schedules.
- Refresh documentation habits. Update clinical templates, narratives, attachment workflows and internal reference material where a revised descriptor changes what the team needs to record. Check current payer requirements rather than assuming every plan wants the same attachment.
- Give January exceptions an owner. Track rejections and requests for information, note the payer and reason, and assign the next step. A small feedback loop in the first weeks of the year can show whether the problem is a code, documentation, software setup or plan rule.
Train by role, not by information avalanche
The whole team does not need the same lesson.
- Clinical team: Which procedures have new or revised reporting options? What details must be documented so the code selection reflects the treatment?
- Scheduling and treatment coordination: Do treatment-plan templates, patient estimates or planned procedures need review?
- Billing team: Which codes changed, what payer instructions are current and how will January exceptions be tracked?
- Software administrator: Which supported version includes the update, which permissions are required and which custom settings must be protected?
A short role-specific review is more useful than forwarding a 198-page manual with “FYI” in the subject line and calling that training.
CDT 2027 questions practices are already asking
When do the CDT 2027 changes take effect?
The ADA says the 2027 code set is effective January 1 through December 31, 2027. Use the code set applicable to the date the procedure was performed and follow the official guidance for your workflow.
Are all 67 changes new codes?
No. The ADA’s total includes 28 additions, 33 revisions and six editorial changes. There are no deletions.
Will adding CDT 2027 codes to Open Dental update our fees?
Do not assume it will. Open Dental documents the annual CDT update under Procedure Code Tools and handles fee schedules through separate procedure-code and fee-schedule functions. Review both areas deliberately and follow the instructions for your installed version.
Does a new CDT code mean insurance will cover the procedure?
No. The ADA explains that a valid CDT code does not guarantee coverage or reimbursement. Benefits depend on the patient’s plan, limitations, exclusions and applicable provider agreement.
Where Paragon fits
Some practices can handle this transition internally with an official reference, a thoughtful software update and a clear owner for the follow-up. That is a perfectly good outcome.
If annual code changes are landing on top of an existing claim backlog, inconsistent follow-up or payment-posting pressure, Paragon’s insurance billing support can help keep the day-to-day billing work moving. For practices using Open Dental, you can also review our Open Dental billing services.
We will still start with a conversation and a real look at what your practice needs. Sometimes the answer is outsourced support. Sometimes the answer is a better internal process and the right tools for your team. We are interested in the answer that makes sense for the practice, not the one that makes the sales pitch easier.
We focus on practice care,
so you can focus on patient care.
Sources checked November 2, 2026. This article provides general educational information. Coding decisions, payer requirements, software configurations and benefit plans vary. Photographs are AI-generated illustrations, not actual Paragon staff, clients or offices.