September 2026 Provider Newsletter

For all providers

News and information for all participating commercial, Medicaid and Medicare providers

Dental Office Toolkit™ (DOT) enhancements

We care about your time. Providers can now manage claims more efficiently with enhanced search and filtering tools, sortable columns, expanded treatment details and CSV export capabilities. These improvements make it easier to find, review and track claims, helping reduce administrative burden and streamline day-to-day claims management.

Paper checks cost you more than money

EFT is a faster, safer and simpler way to get paid. Join more than 80% of participating Indiana offices and enroll in EFT to:

Receive payments faster, often within 48 hours of claim submission.
Enhance security with direct deposits, encryption and multi-factor authentication.
Reduce administrative tasks and spend more time focusing on patient care.

Enroll today by logging into DOT and following the direct deposit link. If you need assistance with DOT, please call Toolkit Support at 866-356-0301. If you have other questions, please contact your professional services representative or see our EFT FAQ.

EFT FAQ

Cracking the code: D4249 (crown lengthening) vs. D4212 (gingivectomy for restorative purposes)

Definitions

According to the American Dental Association’s Code on Dental Procedures and Nomenclature, clinical crown lengthening involves hard tissue (bone) removal in addition to soft tissue removal. This involves a periodontal flap and alteration of the crown to root ratio.

D4249

When doing a crown lengthening, the appropriate code is D4249. Documentation for D4249 should clearly support the restorative need for crown lengthening, the flap and the removal of supporting bone.

Quick tip:

If no bone is removed, D4212 is generally the appropriate code. If bone removal is required to expose additional tooth structure for restoration, use D4249.

For Medicaid and Medicare providers only

News and information for all participating Medicaid and Medicare providers

Medicare Advantage requirement: Type 2 (organization/business) National Provider Identifier

Providers submitting claims for Medicare Advantage members must have a Type 2 National Provider Identifier (NPI) on file for their business. Federal law requires all healthcare providers and organizations use a standard identifier in their administrative and financial transactions.
All electronic claims submitted to Delta Dental must include:

Treating dentist’s Type 1 NPI 
Treating dentist’s state license number 
Tax Identification Number (TIN) of the billing dentist or practice 
Type 2 NPI to identify the billing provider, following these guidelines:
- Multiple dentists at one practice location (group practice, partnership): Type 1 for each dentist and Type 2 for the practice, if claims are transmitted in the practice’s name and TIN.
- Multiple dentists at multiple practices (clinics, dental service organizations, etc.): Type 1 for each dentist and Type 2 for each practice, with a separate TIN.

To register for a Type 2 Billing NPI, please go to the NPI registry. For step-by-step registration instructions, please refer to our guide. Delta Dental does not have access to your application status.

Registration guide