D8080 - Comprehensive Adol
Comprehensive ortho treatment adolescent.
- Procedure Code
- D8080
- Category
- Orthodontics
Insurance Verification Benchmarks & Billing Guidelines
Benchmark Policy Source: Delta Dental 2026
- Frequency Limitation
- Subject to group/individual contract frequency limitations (none)
Required Claim Attachments & Pre-Submission Checklist
- Standard ADA claim form with CDT procedure code and date of service
Bill When (Allowable Clinical Criteria)
- Indicated for medically and clinically necessary treatment as documented in patient's dental record.
Restrictions & Clinical Exclusions
- Infection control is included in the fee for the dental services provided. Separate fees are not billable to the patient.
- All services and treatment provided remotely via tele-health modalities, be they synchronous or asynchronous, must be performed by a licensed dentist or their supervised staff, acting within the scope of applicable law. Services and treatment delivered virtually are only a benefit when the elements included in the descriptor of the CDT procedure code are completed and only when they meet generally accepted clinical guidelines.
- Fees for final orthodontic records (images, photos, and models) are included in the treatment and not billable to the patient.
- Benefits for restorations for altering occlusion, adjusting vertical dimension, replacing tooth structure lost by attrition, erosion, abrasion, abfraction, corrosion, TMD or for periodontal, orthodontic, or other splinting are denied, unless covered by group/individual contract. LIMITED ORTHODONTIC TREATMENT
Common Claim Denial Codes & Overturn Strategies
| Denial Code | Denial Reason | Appeal & Overturn Strategy |
|---|---|---|
| CO-119 | Benefit maximum or frequency limitation exceeded for procedure | Submit clinical narrative detailing extraordinary circumstances, active recurrent pathology, or exception criteria. |
ICD-10 Justification & Crosswalk Mappings
| ICD-10 Code | Diagnosis Name | Category | Primary Justification | Claim Type | Clinical Scenario |
|---|---|---|---|---|---|
| M26.212 | Malocclusion, Angle’s class II | Dentofacial anomalies [including malocclusion] | Yes (Primary) | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Malocclusion, Angle’s class II |
| K00.0 | Anodontia | Disorders of tooth development and eruption | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Anodontia |
| K00.6 | Disturbances in tooth eruption | Disorders of tooth development and eruption | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Disturbances in tooth eruption |
| K08.8 | Other specified disorders of teeth and supporting structures | Other disorders of teeth and supporting structures | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Other specified disorders of teeth and supporting structures |
| M26.213 | Malocclusion, Angle’s class III | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Malocclusion, Angle’s class III |
| M26.24 | Reverse articulation | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Reverse articulation |
| M26.29 | Other anomalies of dental arch relationship | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Other anomalies of dental arch relationship |
| M26.30 | Unspecified anomaly of tooth position of fully erupted tooth or teeth | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Unspecified anomaly of tooth position of fully erupted tooth or teeth |
| M26.31 | Crowding of fully erupted teeth | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Crowding of fully erupted teeth |
| M26.35 | Rotation of fully erupted tooth or teeth | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Rotation of fully erupted tooth or teeth |
| M26.39 | Other anomalies of tooth position of fully erupted tooth or teeth | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Other anomalies of tooth position of fully erupted tooth or teeth |
| M26.4 | Malocclusion, unspecified | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Malocclusion, unspecified |
| M26.81 | Anterior soft tissue impingement | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Anterior soft tissue impingement |
| M26.82 | Posterior soft tissue impingement | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Posterior soft tissue impingement |
| M26.89 | Other dentofacial anomalies | Dentofacial anomalies [including malocclusion] | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Other dentofacial anomalies |
| Q67.4 | Other congenital deformities of skull, face, and jaw | Congenital musculoskeletal deformities of head, face, spine | Secondary | BOTH | comprehensive orthodontic treatment of the adolescent dentition indicated for Other congenital deformities of skull, face, and jaw |