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    [ ] Copy of cdt3procode.d [ ] Copy of cdt3procode.d Document Transcript

    • OVERVIEW OF CHANGES TO UTDB PROCEDURE CODES2000I. CODES ADDEDClinical Oral Evaluation00170 Re-evaluation – limited, problem focused (established patient; not post-operative visit)Radiographs00277 Vertical bitewings – 7 to 8 films00350 Oral/facial images (includes intra and extraoral images) – includes traditional and intraoral photographsTests and Laboratory Examinations00472 Accession of tissue, gross examination, preparation and transmission of written report00473 Accession of tissue, gross and microscopic examination, preparation and transmission of written report00474 Accession of tissue, gross and microscopic examination, including assessment of surgical margins for presence of disease, preparation and transmission of written report00480 Processing and interpretation of cytologic smears, including the preparation and transmission of written reportResin Restorations02337 Resin-based composite crown, anterior-permanent02388 Resin-based composite – four or more surfaces, posterior-permanentInlay/Onlay Restorations02542 Onlay – metallic – two surfacesCrowns-Single Restoration Only02780 Crown – ¾ cast high noble metal02781 Crown – ¾ cast predominately base metal02782 Crown – ¾ cast noble metal02783 Crown – ¾ porcelain/ceramic02799 Provisional crown (not to be used as temporary crown for routine prosthetic restoration)Other Restorative Services02953 Each additional cast post – same tooth (to be used with 02952)02957 Each additional prefabricated post – same tooth (to be used with 02954)Pulpotomy03221 Gross pulpal debridement, primary and permanent teethEndodontic Therapy (including tx plan, clinical procedures, and routine follow up care)03331 Treatment of root canal obstruction; non-surgical access03332 Incomplete endodontic therapy; inoperable or fractured tooth03333 Internal root repair of perforation defectsSurgical Services (Including Usual Postoperative Services)04245 Apically positioned flap04268 Surgical revision procedure, per toothOther Removable Prosthetic Services05867 Replacement of replaceable part of semi-precision or precision attachment (male or female component)05875 Modification of removable prosthesis following implant surgery
    • Implant Supported Prosthetics06056 Prefabricated abutment06057 Custom abutment06058 Abutment supported porcelain/ceramic crown06059 Abutment supported porcelain fused to metal crown (high noble metal)06060 Abutment supported porcelain fused to metal crown (predominantly base metal)06061 Abutment supported porcelain fused to metal crown (noble metal)06062 Abutment supported cast metal crown (high noble metal)06063 Abutment supported cast metal crown (predominantly base metal)06064 Abutment supported cast metal crown (noble metal)06065 Implant supported porcelain/ceramic crown06066 Implant supported porcelain fused to metal crown (titanium, titanium alloy, high noble metal)06067 Implant supported metal crown (titanium, titanium alloy, high noble metal)06068 Abutment supported retainer for porcelain/ceramic FPD06069 Abutment supported retainer for porcelain fused to metal FPD (high noble metal)06070 Abutment supported retainer for porcelain fused to metal FPD (predominately base metal)06071 Abutment supported retainer for porcelain fused to metal FPD (noble metal)06072 Abutment supported retainer for cast metal FPD (high noble metal)06073 Abutment supported retainer for cast metal FPD (predominately base metal)06074 Abutment supported retainer for cast metal FPD (noble metal)06075 Implant supported retainer for ceramic FPD06076 Implant supported retainer for porcelain fused to metal FPD (titanium, titanium alloy, or high noble metal)06077 Implant supported retainer for cast metal FPD (titanium, titanium alloy, or high noble metal)06078 Implant/abutment supported fixed denture for completely edentulous arch06079 Implant/abutment supported fixed denture for partially edentulous archFixed Partial Denture Pontics06245 Pontic – porcelain/ceramicFixed Partial Denture-Inlays/Onlays06519 Inlay/onlay – porcelain/ceramic06548 Retainer – porcelain/ceramic for resin bonded fixed prosthesisFixed Partial Denture Retainers-Crown06740 Crown – porcelain/ceramic06781 Crown – ¾ cast predominately based metal06782 Crown – ¾ cast noble metal06783 Crown – ¾ porcelain/ceramicOther Fixed Partial Denture Services06976 Each additional cast post – same tooth (to be used with 06970 or 06971)06977 Each additional prefabricated post – same tooth (to be used with 06972)Excision of Bone Tissue07471 Removal of exostosis – per siteReduction of Dislocation and Management of Other Temporomandibular Joint Dysfunctions.Procedures which are an integral part of a primary procedure should not be reported separately.07871 Non-arthroscopic lysis and lavageOther Repair Procedures07997 Appliance removal (not by dentist who placed appliance), includes removal of archbarOther Orthodontic Services08691 Repair of orthodontic appliance (functional appliances and palatal expanders)08692 Replacement of lost or broken retainer 2
    • Anesthesia09241 Intravenous sedation/analgesia – first 30 minutes09242 Intravenous sedation/analgesia – each additional 15 minutes09248 Non-intravenous conscious sedationMiscellaneous Services09911 Application of desensitizing resin for cervical and/or root surface, per tooth09971 Odontoplasty 1 – 2 teeth; includes removal of enamel projections09972 External bleaching – per arch09973 External bleaching – per tooth09974 Internal bleaching – per tooth09975 Bleaching agent (non CDT-3 code; replaces 03963)II. CODES DELETED00471 Diagnostic photographs (replaced by 00350)02210 Silicate cement-per restoration02810 Crown-3/4 cast metallic03960* Bleaching of discolored tooth (e.g., non-vital tooth)03961* Bleaching, in office, per arch, per visit (vital teeth)03962* Bleaching, home, per arch (includes trays and bleaching agent)03963* Bleaching Agent04250 Mucogingival surgery-per quadrant07470 Removal of exostosis-maxilla or mandible09240 Intravenous sedation* NOTE: See 09971 – 09975 for replacement codes.III. CODES WITH REVISED DESCRIPTORS00140 Limited oral evaluation – problem focused An evaluation limited to a specific oral health problem. This may require interpretation of information acquired through additional diagnostic procedures separately. Definitive procedures may be required on the same date as the evaluation. Typically, patients receiving this type of evaluation have been referred for a specific problem and/or present with dental emergencies, trauma, acute infections, etc.00150 Comprehensive oral evaluation Typically used by a general dentist and/or a specialist when evaluating a patient comprehensively. It is a thorough evaluation and recording of the extraoral and intraoral hard and soft tissues. It may require interpretation of information acquired through additional diagnostic procedures. Additional diagnostic procedures should be reported separately. This would include the evaluation and recording of the patient’s dental and medical history and a general health assessment. It may typically include the evaluation and recording of dental caries, missing or unerupted teeth, restorations, occlusal relationships, periodontal conditions (including periodontal charting), hard and soft tissue anomalies, oral cancer screening, etc.00425 Caries susceptibility tests Not to be used for carious dentin staining. 3
    • 00501 Histopathologic examinationsD1120 Prophylaxis – childD1351 Sealant – per tooth02000– Restorative02999 A one-surface posterior restoration is one in which the restoration involves only one of the five surface classifications (mesial, distal, occlusal, lingual, or facial, including buccal and labial.) A two-surface posterior restoration is one in which the restoration extends to two of the five surface classifications. A three-surface posterior restoration is one in which the restoration extends to three of the five surface classifications. A four-or-more surface posterior restoration is one in which the restoration extends to four or more of the five surface classifications. A one-surface anterior proximal restoration is one in which neither the lingual nor facial margins of the restoration extend beyond the line angle. A two-surface anterior proximal restoration is one in which both the lingual and facial margins extend beyond the line angle and the incisal angle is involved. This restoration might also involve all four surfaces of an anterior tooth and not involve the incisal angle.02335 Resin-based composite – four or more surfaces or involving incisal angle (anterior) Incisal angle to be defined as one of the angles formed by the junction of the incisal and the mesial or distal surface of an anterior tooth.02380 Resin-based composite – one surface, posterior-primary Used to restore a carious lesion into the dentin or a deeply eroded area into the dentin. Not a preventive procedure.02385 Resin-based composite – one surface, posterior-permanent Used to restore a carious lesion into the dentin or a deeply eroded area into the dentin. Not a preventive procedure.(The following codes 02650-02664, Resin-based composite inlays/onlays, must utilize indirect technique.)02650 Inlay – resin-based composite composite/resin – one surface02651 Inlay – resin-based composite composite/resin – two surfaces02652 Inlay – resin-based composite composite/resin – three or more surfaces02662 Onlay – resin-based composite composite/resin – two surfaces02663 Onlay – resin-based composite composite/resin – three surfaces02664 Onlay – resin-based composite composite/resin – four or more surfaces 4
    • 02940 Sedative filling Temporary restoration intended to relieve pain. Not to be used as a base or liner under a restoration.02960 Labial veneer (resin laminate) – chairside Refers to labial/facial direct resin bonded veneers.02961 Labial veneer (resin laminate) – laboratory Refers to labial/facial indirect resin bonded veneers.02962 Labial veneer (porcelain laminate) – laboratory Refers also to facial veneers that extend interproximally and/or cover the incisal edge. Porcelain/ceramic veneers presently include all ceramic, porcelain, and polymer-reinforced porcelain veneers.03220 Therapeutic pulpotomy (excluding final restoration) – removal of pulp coronal to the dentinocemental junction and application of medicament - Pulpotomy is the surgical removal of a portion of the pulp with the aim of maintaining the vitality of the remaining portion by means of an adequate dressing. - To be performed on primary or permanent teeth - This is not to be construed as the first stage of root canal therapy.04249 Clinical crown lengthening – hard tissue This procedure is employed to allow restorative procedure or crown with little or no tooth structure exposed to the oral cavity. Crown lengthening requires reflection of a flap and is performed in a healthy periodontal environment, as opposed to osseous surgery which is performed in the presence of periodontal disease. Where there are adjacent teeth, the flap design may involve a larger surgical area.04266 Guided tissue regeneration – resorbable barrier, per site A membrane is placed over the root surfaces or defect area following surgical exposure and debridement. The mucoperiosteal flaps are then adapted over the membrane and sutured. The membrane is placed to exclude epithelium and gingival connective tissue from the healing wound. This procedure may require subsequent surgical procedures to correct the gingival contours. Guided tissue regeneration may also be carried out in conjunction with bone replacement grafts or to correct deformities resulting from inadequate faciolingual bone width in an edentulous area. When guided tissue regeneration is used in associationwith a tooth, each site on a specific tooth should be reported separately with this code. When no tooth is present, each site should be reported separately. Definition for the term “site” precedes code 04210.04267 Guided tissue regeneration – nonresorbable barrier, per site (includes membrane removal) This procedure is used to regenerate lost or injured periodontal tissue by directing differential tissue responses. A membrane is placed over the root surfaces or defect area following surgical exposure and debridement. The mucoperiosteal flaps are then adapted over the membrane and sutured. The membrane is placed to exclude epithelium and gingival connective tissue from the healing wound. This procedure requires subsequent surgical procedures to remove the membranes and/or to correct the gingival contours. Guided tissue regeneration may be used in conjunction with bone replacement grafts or to correct 5
    • deformities resulting from inadequate faciolingual bone width in an edentulous area. When guided tissue regeneration is used in association with a tooth, each site on a specific tooth should be reported separately with this code. When no tooth is present, each site should be reported separately. Definition for the term “site” precedes code 04210.04341 Periodontal scaling and root planing, per quadrant This procedure involves instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus from these surfaces. It is indicated for patients with periodontal disease and is therapeutic, not prophylactic, in nature. Root planing is the definitive procedure designed for the removal of cementum and dentin that is rough, and/or permeated by calculus or contaminated with toxins or microorganisms. Some soft tissue removal occurs. This procedure may be used as a definitive treatment in some stages of periodontal disease and/or as a part of pre-surgical procedures in others.04355 Full mouth debridement to enable comprehensive periodontal evaluation and diagnosis The removal of subgingival and/or supragingival plaque and calculus. This is a preliminary procedure and does not preclude the need for other procedures. This procedure may be necessary more than one and may require multiple visits to complete.04910 Periodontal maintenance procedures (following active therapy) This procedure is for patients who have completed periodontal treatment (surgical and/or nonsurgical periodontal therapies exclusive of 04355) and includes removal of the bacterial flora from crevicular and pocket areas, scaling and polishing of the teeth, periodontal evaluation, and a review o the patient’s plaque control efficiency. Typically, an interval of three months between appointments results in an effective treatment schedule, but this can vary depending upon the clinical judgment of the dentist. When new or recurring periodontal disease appears, additional diagnostic and treatment procedures must be considered. Periodic maintenance treatment following periodontal therapy is not synonymous with a prophylaxis.05140 Immediate denture – mandibular Includes limited follow-up care only; does not include required future rebasing/ relining procedure(s) or a complete new denture.05211 Maxillary partial denture – resin base (including any conventional clasps, rests and teeth) Includes acrylic resin base denture with resin or wrought wire clasps.05212 Mandibular partial denture – resin base (including any conventional clasps, rests and teeth) Includes acrylic resin base denture with resin or wrought wire clasps.05850 Tissue conditioning, maxillary Treatment reline using materials designed to heal unhealthy ridges prior to more definitive final restoration.05851 Tissue conditioning, mandibular Treatment reline using materials designed to heal unhealthy ridges prior to more definitive final restoration. 6
    • 05861 Overdenture – partial, by report Describe and document procedures as performed. Other separate procedures may be required concurrent to 05861.06020 Abutment placement or substitution: endosteal implant An abutment is placed to permit fabrication of a dental prosthesis. This procedure may include the removal of a temporary healing cap or replacement with an abutment of alternate design. The intention of this code is to report this procedure by other than the dentist who placed the implant.06200- IX. Prosthodontics, fixed (each retainer and each pontic constitutes a unit in a fixed06999 partial denture. The words “bridge” and bridgework” have been replaced by the statement “fixed partial denture” throughout this section. Classification of Metals – The noble metal classification system has been adopted as a more precise method of reporting various alloys used in dentistry. The alloys are defined on the basis of the percentage of noble metal content: high noble – Gold (Au), Palladium (Pd), and/or Platinum (Pt) > 60T (with at least 40% Au); noble – Gold (Au), Palladium (pd), and/or Platinum (Pt) > 25%; predominantly base – Gold (Au), Palladium (Pd), and/or Platinum (Pt) < 25% Porcelain/ceramic retainers and pontics presently include all ceramic, porcelain, polymer- reinforced porcelain and porcelain fused to metal retainers and pontics. Resin retainers and pontics and resin metal retainers and pontics include all reinforced heat and/or pressue-cured resin materials06920 Connector bar A device attached to fixed partial denture retainer or coping which serves to stabilize and anchor a removable overdenture prosthesis.06950 Precision attachment Report attachment separately from crown; a male and female pair constitutes one precision attachment. Describe type of attachment used.06975 Coping – metal To be used as a definitive restoration.07120 Each additional tooth To be reported for an additional extraction in the same quadrant at the same visit.07230 Removal of impacted tooth – partially bony Part of crown covered by bone; requires mucoperiosteal flap elevation and bone removal.07240 Removal of impacted tooth – completely bony Most or all of crown covered by bone; requires mucoperiosteal flap elevation and bone removal. 7
    • 07285 Biopsy of oral tissue – hard (bone, tooth) For removal of specimen only. This code involves biopsy of osseous lesions and is not used for apicoectomy/periradicular curettage.07286 Biopsy of oral tissue – soft (all others) For surgical removal of specimen only. This code is not used at the same time as codes for apicoectomy/periradicular curettage.07490 Radical resection of mandible with bone graft Enbloc removal of lesion and defect with margin of normal appearing bone. Immediate reconstruction with autogenous and/or allogenic bone graft.07530 Removal of foreign body, skin, or subcutaneous alveolar tissue This may include mucosa.07670 Alveolus – stabilization of teeth, closed reduction splinting Teeth may be wired, banded or splinted together to prevent movement.07710 Maxilla – open reduction Surgical incision required to reduce fracture.07830 Manipulation under anesthesia Usually done under general anesthesia or intravenous sedation.07941 Osteotomy – mandibular rami07943 Osteotomy – mandibular rami with bone graft; includes obtaining the graft07950 Osseous, osteoperiosteal, or cartilage graft of the mandible or facial bones – autogenous or nonautogenous, by report Includes obtaining autograft and/or allograft material. This code may be used for a ridge augmentation and/or sinus lift procedure.09230 Analgesia, anxiolysis, inhalation of nitrous oxide09410 House/extended care facility call Includes visits to nursing homes, long-term care facilities, hospice sites, institutions, etc. Report in addition to reporting appropriate code numbers for actual services performed.09630 Other drugs and/or medicaments, by report Includes, but is not limited to, oral antibiotics, oral analgesics, and topical fluoride dispensed in the office for home use; does not include writing prescriptions.09910 Application of desensitizing medicament Includes in-office treatment of root sensitivity. Typically reported on a “per visit” basis for application of topical fluoride. This code is not be used for bases, liners or adhesives used under restorations. 5/23/00 8