D9310 — Consultation (by another dentist/specialist)

What consultation and visit codes involves

These codes describe the circumstances of a visit rather than a clinical procedure. A consultation (D9310) is reported when a dentist other than the one providing treatment gives a diagnostic opinion at the request of another practitioner or the patient. House calls, hospital visits, office visits outside normal hours and visits where the patient did not appear all have their own codes. Teledentistry codes cover synchronous video consultations and asynchronous review of records sent in. None of them describe treatment. They describe where, when, by whom, and in what capacity.

When this treatment is used

A consultation code is appropriate when a specialist assesses a patient and provides an opinion without necessarily taking over care. Teledentistry codes have become established for triage, follow-up and orthodontic monitoring.

Consultation, or examination?

The distinction payers apply is whether the dentist is providing an opinion or taking over treatment. A specialist who assesses a referred patient, discusses the findings and sends a report back to the referring dentist has performed a consultation. A specialist who assesses the patient and then treats them has performed an examination, and the appropriate evaluation code applies. Reporting both a consultation and an examination on the same date is almost always reduced to one. And a consultation reported by the patient's own general dentist is usually denied, because the relationship is not consultative.

Teledentistry, which is here to stay

The synchronous code covers a real-time video encounter; the asynchronous one covers reviewing photographs or records the patient has sent and responding later. Both are reported alongside whatever clinical service was actually provided — the teledentistry code describes the delivery method, not the treatment. Where it works well: triage of an urgent problem to decide whether it needs to be seen today, post-operative check-ins, reviewing whether a lesion has resolved, and orthodontic progress monitoring. Where it does not: anything requiring examination by touch, anything requiring imaging, and most diagnoses. Coverage has broadened considerably but varies by plan and by jurisdiction.