D9310 is the CDT code for a consultation provided by a dentist or physician other than the requesting dentist. The consulting provider evaluates the patient at the referral of another provider and returns a written report with findings and recommendations. This is a diagnostic service that is distinct from a regular exam performed by the patient's own treating dentist using codes such as D0140 or D0150.
Last updated June 2026 · Reviewed by the PracticeAlpha billing team
Get help with D9310 claims →A general dentist refers a patient to an oral surgeon, periodontist, endodontist, or orthodontist for an opinion on a specific clinical question. The specialist evaluates the patient and sends a written report back to the referring dentist. The specialist bills D9310.
A physician refers a patient to a dentist for evaluation of an oral finding identified during a medical visit. The dentist evaluates the specific concern, documents findings, and provides a written report to the referring physician. D9310 is billed by the consulting dentist.
A patient or provider requests a second opinion from a different dentist regarding a proposed treatment plan. The second dentist reviews records, examines the patient, and provides a written opinion. The consulting dentist bills D9310 for this service.
Do NOT use D9310 for: A regular new patient or recall exam performed by the patient's own treating dentist (use D0150 or D0120). A limited exam by the treating dentist for a specific complaint (use D0140). Any situation where the same dentist both requested and performed the evaluation. Routine specialist exams that are not initiated by a formal referral from another provider. Initial visits to a specialist that function as intake exams rather than formal consultations.
The three requirements for D9310: A requesting provider who formally referred the patient, a consulting provider who is a different person or entity, and a written report returned to the requesting provider documenting findings and recommendations.
The most common reason D9310 is denied is that the claim does not reflect a true consultation. The service must originate from a formal referral by another provider. If the patient self-referred to a specialist, or if there is no written report returned to the requesting dentist, the payer may deny D9310 and request that a standard exam code be submitted instead. Keep the referral documentation and a copy of the written report in the patient chart.
Some payers require the consulting and requesting providers to be unrelated entities. If the consulting dentist and the referring dentist are employed by the same group practice or share the same tax ID, the payer may deny D9310 on the grounds that it does not meet the definition of an external consultation. Review each payer's specific policy before billing.
When a specialist performs D9310 and then proceeds directly to treatment on the same date, some payers will bundle the consultation into the treatment fee and deny the consultation separately. Check each plan's bundling rules. If treatment is expected to follow the consult on the same day, consider whether the plan will reimburse both services or only the treatment.
Not all dental plans include D9310 as a covered benefit. Some plans do not cover consultations as a standalone service. Verify benefits before the appointment. When D9310 is non-covered, inform the patient of their financial responsibility in advance.
Document the formal referral in the patient chart. This should include the name of the requesting dentist or physician, the reason for referral, and the clinical question being asked. A written referral letter or documented phone/electronic referral is acceptable. This establishes the consultation relationship.
A written report summarizing the evaluation findings, diagnosis, and recommendations must be sent back to the requesting dentist or physician. This is a defining element of D9310. The absence of a written report to the referring provider means the service was not a formal consultation. Keep a copy in the patient record.
Document the examination findings, review of records or radiographs, diagnosis, and recommendations. Include the date of service, the specific clinical question that prompted the referral, and how you addressed it. Notes should be thorough enough to justify the consultation service independently.
If the consultation involved reviewing existing radiographs, models, or treatment records provided by the referring dentist, document what was reviewed and how those findings informed the consultation. This supports the clinical complexity and value of the service.
Some plans require pre-authorization for D9310. Verify benefit requirements before the appointment. If pre-auth is required and not obtained, the claim will typically be denied. Document the authorization number in the chart and include it on the claim form.
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Learn about our billing servicesD9310 is the CDT code for a consultation, a diagnostic service provided by a dentist or physician who is different from the requesting provider. It requires a formal referral, an evaluation by the consulting provider, and a written report returned to the requester. It is not an exam performed by the patient's own treating dentist.
D0150 is a comprehensive oral evaluation by the patient's own treating dentist. D9310 is a formal consultation by a different provider at the request of the treating dentist or physician. The consultation relationship and the written report back to the requester distinguish D9310 from any exam code in the D01xx range.
The consulting provider bills D9310. This is the dentist or physician who received the referral, evaluated the patient, and provides the written report. The requesting dentist does not bill D9310 for making the referral.
Yes. A written report documenting findings and recommendations that is returned to the requesting provider is a required element of a formal consultation. Without this written communication, the service does not meet the CDT definition of D9310 and should be billed as an appropriate exam code instead.
Common denial reasons include no formal referral on file, no written report returned to the requesting provider, the consulting and referring providers sharing the same practice or tax ID, bundling of the consultation with same-day treatment, or the plan not covering D9310 as a standalone benefit.
It depends on the payer. Some plans bundle D9310 with treatment performed on the same date and pay only for the treatment. Others allow both codes. Check the specific plan's bundling rules before billing both on the same date of service.
Search all 206 CDT codes in our dental coding guide.