Learn LANAP and LAPIP coding for laser dentistry, including recommended CDT codes, billing tips, and documentation practices for accurate insurance claims.

Coding LANAP® and LAPIP® Laser Procedures in Dentistry

By Estela Vargas, CRDH, Remote Sourcing

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The Importance of LANAP® and LAPIP® Coding in Laser Dentistry

Much has been written about laser use in dentistry in the last two decades.  Many more dentists have invested in lasers as their best tools for successful dentistry.  As laser technology has developed and specialized, there is much controversy about whether a laser is a “tool” or a “procedure” when documenting clinical notes and billing dental insurance plans for reimbursement.

The term “laser” stands for light amplification by stimulated emission of radiation. The light of a regular light bulb contains many wavelengths and spreads in all directions, while laser light has an exact wavelength. A laser is focused in a collimated narrow beam, generating a very high-intensity light. Since lasers can accurately focus on exact areas, they are used for precise surgical work or cutting through tissue (instead of a scalpel or electrosurgery). 

Challenges in Coding for Laser Procedures

Many dentists are frustrated when they discover that the ADA’s Current Dental Terminology (CDT) manual does not include separate specific “laser” codes.

Code D7465 (destruction of the lesion by cryo, laser, or electro surgery by physical or chemical method, by report) is the only procedure code specifically technique-sensitive to the laser. The code implies that rather than being surgically removed, the pathologic lesion is simply obliterated by the laser.

For all other procedures where the laser is used, the CDT recommends reporting the code that most accurately describes the intended and the completed procedure. Current definitions state that laser and cutting or scalpel techniques are coded the same because they are the instruments used to accomplish the procedure but are not the “procedure” itself. 

Understanding LANAP® and LAPIP® Procedures

Dentists investing in lasers expect to receive a return on investment for improving patient treatment experiences. They desire to bill the patient and the insurance plan for laser procedures. Many types of lasers are on the market, and the cost can vary from around $6,000 to $100,000 depending on the technology and expected benefits.  Today’s advanced lasers empower dentists to perform innovative procedures, enhance the efficiency of existing treatments, and significantly reduce healing time. Thanks to the evolution of laser technology, this promising future of dentistry is within reach. 

Two common laser procedures in dentistry are LANAP® (Laser-Assisted New Attachment Procedure) and LAPIP® (Laser-Assisted Peri-Implantitis Procedure). These are FDA-approved treatments that offer innovative, minimally invasive approaches to periodontal therapy:

• LANAP: Utilizes the PerioLase® MVP-7™ laser to target infected tissue around teeth without harming healthy tissue. LANAP is a non-surgical alternative to traditional osseous surgery.
• LAPIP: Adapts the LANAP protocol specifically for peri-implantitis treatment. LAPIP targets diseased tissue around dental implants with precision, removing infection while preserving surrounding healthy tissue.

LANAP/LAPIP doesn't fall under the osseous surgery category, to the dismay of many dentists and surgeons who believe it should. In 2014, CDT updated the definition of the Osseous Surgery code and added details about the "full-thickness flap."

Recommended CDT Codes for LANAP and LAPIP

Coding claims for LANAP and LAPIP (using lasers instead of cutting instruments or electrosurgery)

If the doctor does not feel that any CDT periodontal codes accurately report the procedure, then D4999 (unspecified periodontal treatment, by report) may be reported with a narrative to describe the method and provide proper documentation. 

• Code D4999, unspecified periodontal procedure, by report,  can be used to describe the laser procedure with as much detail as possible.
• Code  D6199, unspecified implant procedure, by report,  can be used to describe the laser procedure in as much detail as possible.

Training and Coding Accuracy for Laser Procedures

When a laser is introduced into the practice, dental team members must receive comprehensive training in its use and the values it brings to patient treatment. This not only ensures the safe and effective operation of the laser but also equips them with the knowledge to explain laser procedures to patients. The business staff must understand accurately reporting laser procedures and calculating insurance reimbursement to ensure patients understand the value of the services.

Advocating for Specific LANAP and LAPIP Codes

It is important to remember that CDT codes are reviewed annually by the Code Maintenance Committee (CMC). Various codes have been requested to describe some unique treatments performed with lasers for several years. Dentists should continue to push for changes, as the CMC maintains that a laser is simply a tool used to complete a procedure and is not a unique one that stands on its own.  I have based my coding recommendations on the American Academy of Periodontology and the American Dental Association's stance on coding for lasers. 

Remember that the dentist/surgeon chooses a CDT code that best describes the intended and completed procedure.  I will continue to recommend that doctors code laser procedures as D4999 for LANAP and D6199 for LAPIP until the CDT coding committee changes its stance or designates a code for them.

Disclaimer: This blog is for informational purposes only and does not constitute financial, legal, or medical advice. Always consult with a qualified professional or licensed practitioner for specific advice related to coding, billing, or any other area of practice.