D9986 is the CDT code for a missed appointment — an administrative code used to document that a scheduled patient did not show, often when the office charges a missed-appointment fee under its policy. It is generally a non-covered, internal-tracking code, not a clinical procedure.
Informational only — confirm the official CDT descriptor and your payers' rules independently. This is general guidance, not billing, coding, or clinical advice.
When to Use the D9986 Code
Use D9986 to record a no-show — a patient who fails to attend a scheduled appointment, typically without adequate notice. It is an administrative/adjunctive code for documenting the missed visit and, where your policy allows, supporting a missed-appointment charge to the patient's account.
Don't confuse it with the cancellation code: a patient who calls to cancel (rather than simply not appearing) is documented with D9987, the cancelled-appointment code. D9986 is specifically the no-show. It is also not a code you submit to insurance for reimbursement — most carriers do not pay missed-appointment fees, so these are patient-responsibility charges governed by your office policy, not a clinical service.
Documentation & Clinical Scenarios
Because D9986 supports a fee and a record rather than treatment, the documentation centers on policy and notice:
- The scheduled date/time and the provider/column that went unused.
- That the patient did not appear and whether any notice was given.
- Your missed-appointment policy and that the patient was informed of it (ideally a signed acknowledgment on file).
- The fee charged, if any, posted to the patient's account per your policy.
No clinical service is rendered, so there is no tooth number, radiograph, or narrative of care — the record is about the missed visit and the financial policy applied.
Insurance & Billing Tips
- Treat it as patient-responsibility, not a claim. Most plans do not reimburse missed-appointment fees, and many prohibit billing the patient for a covered-service no-show; D9986 is generally internal documentation.
- Have a written policy. A clear, signed missed-appointment policy is what makes a fee defensible; without it, charging a fee can create disputes.
- Don't bill insurance for the fee. Submitting D9986 to a payer for reimbursement is typically futile and may conflict with provider-contract terms.
- Be consistent. Apply the policy uniformly across patients to avoid the appearance of unfair treatment.
- Use it to track patterns. Logging no-shows with D9986 helps identify chronic patterns and supports schedule and recall decisions.
Example Case
A patient is scheduled for a 60-minute restorative visit and never arrives or calls. The front desk confirms the appointment time and provider column went unused, notes that the patient had signed the office's missed-appointment policy at intake, and documents the no-show with D9986. Per that policy, a missed-appointment fee is posted to the patient's account — not submitted to insurance. The office logs the event so it can track whether this becomes a pattern and adjust how it confirms and reminds this patient going forward.
Patients call to rebook the visit, not to discuss a code. DentalReception AI answers and books those calls 24/7, fills the opened slot from your waitlist, and routes fee questions to your team. See how it handles no-show recovery, or book a demo.
Frequently Asked Questions
What's the difference between D9986 and D9987?
D9986 documents a missed appointment (no-show) — the patient simply did not appear. D9987 documents a cancelled appointment — the patient contacted the office to cancel. Both are administrative codes used for tracking and, where policy allows, fees; the distinction is whether the patient gave notice or just failed to show.
Will insurance reimburse a D9986 missed-appointment fee?
Generally no. Most dental carriers do not pay missed-appointment fees, and D9986 is typically used internally to document the no-show and post a patient-responsibility charge per your policy. Some provider contracts also restrict billing patients for missed covered-service appointments, so review your payer agreements before charging.
Can we charge a fee for any missed appointment?
Only if your office has a clear, communicated policy — ideally one the patient signed at intake. A documented missed-appointment policy applied consistently across patients is what makes a fee defensible. Charging without a written, acknowledged policy, or applying it unevenly, invites disputes and can create compliance concerns.
Do we submit D9986 on an insurance claim?
Usually not for reimbursement. D9986 is an administrative code primarily for internal documentation of the no-show and any patient charge. Submitting it to a payer expecting payment is generally unproductive, and some contracts address how missed appointments may be handled, so confirm your specific payer rules before taking any billing action.
Confirm the current CDT descriptor and your specific payer policies before billing — browse the full dental code library or see our insurance verification feature.