Most common D5200 code reviews : Typical crown benefits for the replacement of an existing crown range from five to seven years before a replacement crown payment will be permitted, Non-ionizing diagnostic procedure capable of quantifying, monitoring and recording changes in structure of enamel, dentin and cementum or Accession of tissue, gross examination, preparation and transmission of written report.
Prophylaxis-adult. For payment purposes, the distinction between the adult and child dentition is determined by contract. Any fee in excess is Disallowed and not chargeable to the Patient. In the absence of group contract language regarding age, a person age fourteen (14) and older is considered an adult for benefit determination purposes of a prophylaxis-adult.
Separation of one or more connections between abutments and/or pontics when some portion of a fixed rosthesis is to remain intact D5200 and serviceable following sectioning and extraction or other treatment Includes all recontouring and olishing of retained portions.
A patient presents with a carious pulp exposure of tooth T There is no succedaneous tooth #29 present on a radiograph The roots of this tooth are of adequate length to allow normal function Endodontic treatment is requested on tooth T in order to maintain this tooth in the arch and facilitate the placement of a functional, final restoration. Root canal treatment is performed on the tooth, and the canals are filled with gutta-percha. A temporary restoration is placed, and the patient is referred back to the referring dentist for a final restoration.
Sealant repair - per tooth - This procedure is disallowed when performed by the same dentist/dental office based on the same time limitation that exists for replacement of a sealant. It is allowed at 50% of D5200 when performed by a different provider or if after the time limitation for the same dentist.