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Code on dental procedures and nomenclature
ASSOCIATION
tivities is that, in general, older people retain activity patterns and preferences developed earlier in life. If people are not participating in these activities during the middle years, why r exp ect them to begin in retirem ent? This suggests that leisure competence should be learned early in life. Doing so may be the only way to ensure leisure com petence in later life. In mentioning preparation for retirement, den tists tended to emphasize finances, health, and psychologic readiness. Few, if any, dentists suggested preparing for a life of leisure as a y component of preparation for retirement.
Sum m ary
This paper reports on the results of a national survey of retired dentists carried out in the winter and spring of 1984. More than eight in ten of the respondents were general practitio ners. Most retirees are between the ages of 60 and 69, married, and report their overall health at retirement to be excellent or good. As do retired s c ie n tists , d en tists find in trin s ic gratification in the work role, but apparently accept retirement as part of the life cycle. Re tired d en tists have in com e su b sta n tia lly greater than retirees in general. As is the case ■* for the greater majority of older Americans, Social Security provides an important income i support for respondent dentists. However, the ^ primary source of retirement incom e for den| tists comes from savings and investments. One I of three retired dentists reports net worth in I 1984 as between $200-$499,999. I Retired dentists are well adjusted to retire ment. Overall, most dentists report high satis faction with retirement to date. Additional lei
sure time for hobbies, flexibility in owning one’s time, and social activities with family and friends seem the main contributors to this satisfaction. Investment planning, health as sessment, enthusiasm for outside interests, and personal preparation for retirement with a spouse are reported as important in retirement planning. Retirement is not a satisfying experience for a ll dentists. Som e do report experiencing uselessness and depression. A still smaller proportion report feelings of loneliness and inadequacy. As is the case for older people in general, solitary activities including reading, watching television, and gardening are important for re tired dentists. Most older people attempt to re tain activ ity patterns and preferences de veloped earlier in life. By action, if not words, retired dentists seem to be recommending to their younger counterparts that preparation for a life of leisure be a component of preparation for retirement.
_________________________________ J£ O A \ T h is rep o rt w as approved by th e c o u n c il in November 1984.
Dr. Jackson is a pedodontist and financial planner, Charleston, SC; Dr. Kart is chairman, department of sociology, anthropology, and social work, University of Toledo, Toledo, OH; Ms. Wagner is head, survey operations, American Dental Association, Bureau of Econom ic and Behavioral Research; and Dr. Rowe is research consultant, Health Science Center, San An tonio, University of Texas. Address requests for re prints to the council, 211 E Chicago Ave, Chicago, 60611.
REPORTS
1. Bureau of Econom ic and Behavioral Research, Am erican Dental Association, 1982 distribution of dentists in the United States by region and state. 2. Siegel, J. Demographic aspects of aging and the older population in the US. Washington, DC, U S De partment of Commerce, Bureau of the Census, CPR, Series P-23, no. 59, 1976. 3. Com parison based on data from th e Health Interview Survey, National Center for Health Statis t ic s , D iv is io n o f H e a lth In te rv ie w S t a t i s t i c s , Rockville, MD, 1976. 4. Bureau of the Census. M oney incom e and pov erty status of fam ilies and persons in the U S: 1982. Washington, DC, US Department o f Commerce, CPR, Series P-60, no. 140, 1983. 5. Grad, S. Income of the population 55 and over. Washington, DC, Social Secu rity A dm inistration, 1983. 6. Brotman, H. The aging of Am erica: a demo graphic profile. National J, p 1626, Oct 7, 1978. 7. Kart, C. The realities of aging, ed 2. Boston, Allyn & Bacon, 1985. 8. Beck, S. Adjustm ent to and satisfaction with retirement. J Gerontology 37(5):616-624, 1982. 9. Patton, C. Early retirement in academ ia: making the decision. Gerontologist 17(4):347-354, 1977. 10. M iller, S. T he social dilem m as of the aging leisure participant. In Rose, A., and Peterson, W .,eds. Older people and their social world. Philadelphia, F.A. Davis, 1965. 11. Atchley, R. Retirement and leisure participa tion: continuity or crisis? Gerontologist 11:13-17, 1971. 12. Ellison, D. Work retirem ent and the sick role. Gerontologist 8:189-192, 1968. 13. Snow, A., and Havighurst, R. Life style types and patterns of retirem ent of educators. Gerontologist 17(6):545-552, 1977. 14. Riley, M., and Foner, A. Aging and society. Vol 1— An inventory of research findings. New York, Russell Sage Foundation, 1968. 15. Rowe, A.R. Scientists in retirement. J Gerontol 28:345-350, 1973.
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Code on dental procedures and nomenclature
Council on Dental Care Programs The fifth revision of the Code on Dental Proce dures and Nomenclature is the result of several years of research and negotiations with insur’ ance industry representatives. The Code origi nally was developed and published in The Journal in 1969. Subsequent revisions were published in 1972 (JADA 85(4):789-792,1972); 1976 (JADA 92(3):647-652, 1976); and 1982 (JADA 104(3):351-356, 1982). In 1979, the Council com piled the Codes f o r Most Fre q u e n tly Reported D ental Procedures, a con' densed version for use as an easy reference for the dental office staff (JADA 9 8 (l):7 9 -8 0 ,1979). The com pilation contained several procedure codes that differed from the 1976 version, and the prefatory text noted that the wording in the more recent document took precedence. As with previous revisions, this latest ver
sion of the Code was developed in cooperation with practicing dentists throughout the United States, n atio n al dental organizations, the Health Insu rance A ssociation of A m erica, Delta Dental Plans Association, and Blue Cross and Blue Shield Associations. Copies of the Code are available from the Council.
Procedures covered Although the Code includes primarily the den tal services most frequently provided in a den tal office, it also lists dental services that are performed in hospitals. Diagnostic services common to most categories of treatment are grouped and listed generally in the sequence of treatment. To avoid duplication, other proce dures that are performed by general practitio ners and specialists alike have been grouped
under the specialty category with w hich the procedures are most frequently identified. The groupings according to specialty categories are solely for convenience in using the Code and should not be interpreted as excluding general practitioners from perform ing such proce dures. The purpose of these codes and nom encla ture is to facilitate the com pletion of dental prepayment claims in the dental office and processing in the claims office. The inclusion of a procedure in the Code provides only a means of reporting that procedure and has no effect on the terms of dental benefit contracts. Any dentist who finds that the nom enclature contained in this document does not accu rately describe a procedure should not use that code, but should instead provide a narrative report. JADA, Vol. 110, M arch 1985 ■ 389
A S S O C IA T IO N
REPORTS
The procedures included in the Code for Most Frequently Reported Dental Procedures are the procedures most often benefited under dental plans, and therefore remain the princi pal administrative aid to most dentists and their office staffs. It is printed here for conven ient reference.
Coding system The Code is a five-digit system to identify den tal procedures and services. The basic categories are: Category of service I II m IV V VI * VII
vm IX X XI
Diagnostic Preventive Restorative Endodontics Periodontics Prosthodontics, removable Maxillofacial prosthetics Prosthodontics, fixed Oral surgery Orthodontics Adjunctive general services
Code series
00100-00999 01000-01999 02000-02999 03000-03999 04000-04999 05000-05899 05900-05999 06000-06999 07000-07999 08000-08999 09000-09999
00100-00999 I. Diagnostic Clinical oral examinations 00110 Initial oral examination 00120 Periodic oral examination 00130 Emergency oral examination Radiographs 00210 Intraoral— complete series (including bitewings) 00220 Intraoral— periapical—first film 00230 Intraoral— periapical—each additional film 00240 Intraoral-occlusal film 00250 Extraoral— first film 00260 Extraoral— each additional film 00270 Bitewing— single film 00272 Bitewings—two films 00274 Bitewings— four films 00275 Bitewings— each additional film 00290 Posteroanterior and lateral skull and facial bone, survey film 00310 Saliography 00320 Temporomandibular joint arthrogram, including injection 00321 Other temporomandibular joint films, by report 00330 Panoramic film 00340 Cephalometric film Tests and laboratory examinations 00410 Bacteriologic studies for determination of pathologic agents 00420 Caries susceptibility tests 00460 Pulp vitality tests 00470 Diagnostic casts 00471 Diagnostic photographs 00501 Histopathologic examinations 00502 Other oral pathology procedures, by report 00999 Unspecified diagnostic procedure, by report 01000-01999 Q. Preventive Dental prophylaxis OHIO Prophylaxis— adult 01120 Prophylaxis— child 390 ■ JADA, V o l. 110, M arch 1985
T opical fluoride treatment (office procedure) 01201 Topical application of fluoride (including prophylaxis)— child 01202 Topical application of fluoride (including prophylaxis)— adult 01203 Topical application of fluoride (excluding prophylaxis)— child 01204 Topical application of fluoride (excluding prophylaxis)— adult Other preventive services 013 1 0 Dietary planning for the control of dental caries 01330 Oral hygiene instruction 01351 Sealant— per tooth Space m aintenance (passive appliances) 01510 Space maintainer—fixed—unilateral 01515 Space maintainer—fixed—bilateral 01520 Space maintainer— removable— unilateral 01525 Space maintainer—removable—bilateral 01550 Recementation of space maintainer 02000-02999 IH. Restorative Amalgam restorations (including polishing) 02 1 1 0 Amalgam—one surface, primary 02120 Amalgam—two surfaces, primary 02130 Amalgam—three surfaces, primary 02131 Amalgam—four surfaces, primary 02140 Amalgam— one surface, permanent 021-50 Amalgam—two surfaces, permanent 02160 Amalgam—three surfaces, permanent 02161 Amalgam—four or more surfaces, permanent Silicate restorations 02 2 1 0 Silicate cement—per restoration Filled or unfilled resin restorations 02330 Resin— one surface 02331 Resin— two surfaces 02332 Resin— three surfaces 02335 Resin— four or more surfaces or involving incisal angle Gold foil restorations 02410 Gold foil— one surface 02420 Gold foil—two surfaces 02430 Gold foil—three surfaces Inlay restorations 02510 Inlay— metallic—one surface 02520 Inlay— metallic—two surfaces 025 3 0 Inlay— metallic—three surfaces 025 4 0 Onlay—metallic—per tooth (in addition to inlay) 026 1 0 Inlay— porcelain/ceramic—one surface 02620 Inlay— porcelain/ceramic—two surfaces 02630 Inlay— porcelain/ceramic—three surfaces Crowns—single restoration only 02710 Crown— resin (laboratory) 02720 Crown—resin with high noble metal 02721 Crown—resin with predominantly base metal 02722 Crown—resin with noble metal 02740 Crown— porcelain/ceramic substrate 02750 Crown— porcelain fused to high noble metal 02751 Crown— porcelain fused to predominantly base metal 02752 Crown— porcelain fused to noble metal 02790 Crown—full cast high noble metal 02791 Crown—full cast predominantly base metal 02792 Crown— full cast noble metal 02810 Crown— % cast metallic Other restorative services 02910 Recement inlay 02920 Recement crown 02930 Prefabricated stainless steel crown— primary tooth
02931 Prefabricated stainless steel crown— permanent tooth 02932 Prefabricated resin crown 02940 Sedative filling 02 9 5 0 Crown buildup, including any pins 02951 Pin retention—per tooth, in addition to restoration 02952 Cast post and core in addition to crown 02953 Cast post as part of crown 02954 Prefabricated post and core in addition to crown 02960 Labial veneer (laminate) 02970 Temporary (fractured tooth) 02980 Crown repair, by report 02999 Unspecified restorative procedure, by report 03000-03999 IV. Endodontics Pulp capping 03110 Pulp cap— direct (excluding final restoration) 03120 Pulp cap— indirect (excluding final restoration) Pulpotomy 03220 Therapeutic pulpotomy (excluding final restoration) Root canal therapy (including treatment plan, clinical procedures, and follow-up care) 03310 One canal (excluding final restoration) 03320 Two canals (excluding final restoration) 03330 Three canals (excluding final restoration) 03340 Four or more canals (excluding final restoration) 03350 Apexification (per treatment visit) Periapical services 03410 Apicoectomy (per tooth)— first root 03411 Apicoectomy (per tooth)— each additional root 03430 Retrograde filling— per root 03440 Apical curettage 03450 Root amputation—per root 03460 Endodontic endosseous implant Other endodontic procedures 03910 Surgical procedure for isolation of tooth with rubber dam 03920 Hemisection (including any root removal), not including root canal therapy 03940 Recalcification or repair (perforations, root resorption, etc) 03950 Canal preparation and fitting of preformed dowel or post 03960 Bleaching of discolored tooth 03999 Unspecified endodontic procedure, by report 04000-04999 V. Periodontics Surgical services (including usual postoperative services) 04210 Gingivectomy or gingivoplasty— per quadrant 04211 Gingivectomy or gingivoplasty—per tooth 04220 Gingival curettage, by report 04240 Gingival flap curettage (including root planing) 04260 Osseous surgery (including flap entry and closure)— per quadrant 04261 Osseous graft—single site (including flap entry, closure, and donor site) 04262 Osseous graft—multiple sites (including flap entry, closure, and donor sites) 04270 Pedicle soft tissue graft procedure 04271 Free soft tissue graft procedure (including donor site) 04272 Apically repositioning flap procedure
A S S O C IA T IO N
Adjunctive periodontal services 04320 Provisional splinting— intracoronal 04321 Provisional splinting— extracoronal 04340 Root planing— entire mouth 04341 Root planing—per quadrant Other periodontal services 04910 Periodontal maintenance procedures following active therapy (periodontal prophylaxis) 04920 Unscheduled dressing change (by someone other than treating dentist) 04999 Unspecified periodontal procedure, by report 05000-05999 VI. Prosthodontics (removable) Complete dentures (including routine postdelivery care) 05110 Complete upper 05120 Complete lower 05130 Immediate upper 05140 Immediate lower Partial dentures (including routine postdelivery care) 05211 Upper partial—acrylic base (including any conventional clasps and rests) 05212 Lower partial— acrylic base (including any conventional clasps and rests) 05213 Upper partial— predominantly base cast base with acrylic saddles (including any conventional clasps and rests) 05214 Lower partial— predominantly base cast base w ith acrylic saddles (including any conventional clasps and rests) 05215 Upper partial—high noble cast base with acrylic saddles (including any conventional clasps and rests) 05216 Lower partial— high noble cast base with acrylic saddles (including any conventional clasps and rests) 052 80 Removable unilateral partial denture— one piece high noble casting, clasp attachments— per unit (including pontics) 05281 Removable unilateral partial denture— one piece predominantly base casting, clasp attachments— per unit (including pontics) Adjustments to dentures 05410 Adjust complete denture—upper 05411 Adjust complete denture—lower 05421 Adjust partial denture— upper 05422 Adjust partial denture— lower Repairs to com plete dentures 05510 Repair broken complete denture base 05520 Replace missing or broken teeth— complete denture (each tooth) Repairs to partial dentures 05610 Repair acrylic saddle or base 05620 Repair cast framework 05630 Repair or replace broken clasp 05640 Replace broken teeth—per tooth 05650 Add tooth to existing partial denture 05660 Add clasp to existing partial denture Denture 05710 05711 05720 05721
rebase procedures Rebase complete upper denture Rebase complete lower denture Rebase upper partial denture Rebase lower partial denture
Denture 05730 05731 05740 05741 05750 05751 05760
reline procedures Reline upper complete denture (chairside) Reline lower complete denture (chairside) Reline upper partial denture (chairside) Reline lower partial denture (chairside) Reline upper complete denture (laboratory) Reline lower complete denture (laboratory) Reline upper partial denture (laboratory)
05761 Reline lower partial denture (laboratory) Other removable prosthetic services 058 1 0 Temporary complete denture (upper) 05811 Temporary complete denture (lower) 05 8 2 0 Temporary partial— stayplate denture (upper) 05821 Temporary partial— stayplate denture (lower) 05 8 5 0 Tissue conditioning— per denture unit 05 8 6 0 Overdenture— complete, by report 05861 Overdenture— partial, by report 05862 Precision attachment, by report 05 8 9 9 Unspecified removable prosthodontic procedure, by report 0 5900-05999 VII. M axillofacial prosthetics E xtraoral prostheses (including three months’ maintenance) 05911 Facial moulage (sectional) 05912 Facial moulage (complete) 05913 Nasal prosthesis 05 9 1 4 Auricular prosthesis 05915 Orbital prosthesis 05 9 1 6 Ocular prosthesis 05 9 1 7 Composite facial prosthesis 05918 Replacement prosthesis 05919 Prosthetic dressing 05 9 2 0 Ocular implant 05921 Orbital implant Intraoral prostheses—acquired defects 05931 Surgical obturator 05932 Postsurgical obturator 05933 Refitting of obturator 05934 Mandibular resection (flange) prosthesis 0 5 9 3 5 Mandibular resection (denture) prosthesis Intraoral prostheses— congenital defects 05951 Feeding aid 05952 Pediatric speech aid 05953 Adult speech aid 0 5 9 5 4 Superimposed prosthesis 05955 Palatal lift prosthesis 0 5 9 5 6 Obturator 05 9 5 7 Speech bulb Implants—facial, mandibular, cranial 05971 Simple implant 05972 Complex implant 05973 Subperiostial implant 05974 Endosseous implant (in the bone) 05976 Mandibular staple implant Treatm ent prostheses 05982 Surgical stent 05983 Radiation carrier 05984 Radiation shield 05985 Docking device— cone locator 0 5 9 8 6 Fluoride applicator—per arch 0 5 9 9 9 Unspecified maxillofacial prosthesis, by report 06000-06999 VII. Prosthodontics, fixed (Each abutment and each pontic constitutes a unit in a bridge.) Bridge pontics 06210 Pontic— cast high noble metal 06211 Pontic— cast predominantly base metal 06212 Pontic— cast noble metal 06 2 4 0 Pontic—porcelain fused to high noble metal 06241 Pontic— porcelain fused to predominantly base metal 06242 Pontic— porcelain fused to noble metal 0 6 2 5 0 Pontic— resin with high noble metal 06251 Pontic— resin with predominantly base metal 06252 Pontic—resin with noble metal Retainers 065 2 0 Inlay—metallic—two surfaces
REPORTS
06530 Inlay—metallic—three or more surfaces 06540 Inlay—metallic— onlaying cusps 06545 Cast metal retainer for acid etch bridge Bridge retainers—crowns 06720 Crown—resin with high noble metal 06721 Crown—resin with predominantly base metal 06722 Crown—resin with noble metal 06750 Crown— porcelain fused to high noble metal 06751 Crown— porcelain fused to predominantly base metal 06752 Crown—porcelain fused to noble metal 06780 Crown—% cast high noble metal 06790 Crown—full cast high noble metal 06791 Crown—full cast predominantly base metal 06792 Crown— full cast noble metal Other fixed prosthetic services 06930 Recement bridge 06940 Stress breaker 06950 Precision attachment 06970 Cast post and core in addition to bridge retainer 06971 Cast post as part of bridge retainer 06972 Prefabricated post and core in addition to bridge retainer 06980 Bridge repair, by report 06999 Unspecified fixed prosthodontic procedure, by report 0 7000-07999 IX. Oral surgery Extractions—includes local anesthesia and routine postoperative care 07110 Single tooth 07120 Each additional tooth 07130 Root removal— exposed roots Surgical extractions— includes local anesthesia and routine postoperative care 07210 Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth 07220 Removal of impacted tooth—soft tissue 07230 Removal of impacted tooth—partially bony 07240 Removal of impacted tooth— completely bony 07241 Removal of impacted tooth— completely bony, with unusual surgical complications 07250 Surgical removal of residual tooth roots (cutting procedure) Other surgical procedures 07260 Oroantral fistula closure 07270 Tooth re-implantation and/or stabilization of accidentally evulsed or displaced tooth and/or alveolus 07271 Tooth implantation 07272 Tooth transplantation 07280 Surgical exposure of impacted or unerupted tooth for orthodontic reasons (including orthodontic attachments) 07281 Surgical exposure of impacted or unerupted tooth to aid eruption 07285 Biopsy of oral tissue—hard 07286 Biopsy of oral tissue— soft 07290 Surgical repositioning of teeth 07291 Transseptal fiberotomy Alveoloplasty— surgical preparation of ridge for dentures 07310 Alveoloplasty in conjunction with extractions— per quadrant 07320 Alveoloplasty not in conjunction with extractions— per quadrant Vestibuloplasty 07340 Vestibuloplasty—ridge extension (secondary epithelialization) JADA, V ol. 110, M arch 1985 ■ 391
A S S O C IA T IO N
REPORTS
07350 Vestibuloplasty—ridge extension (including soft tissue grafts, muscle re-attachments, revision of soft tissue attachment, and management of hypertrophied and hyperplastic tissue) Surgical excision o f reactive inflammatory lesions (scar tissue or localized congenital lesions) 07410 Radical excision—lesion diameter up to 1.25 cm 07420 Radical excision—lesion diameter over 1.25 cm Removal of tumors, cysts, and neoplasms 07430 Excision of benign tumor—lesion diameter up to 1.25 cm 07431 Excision of benign tumor— lesion diameter over 1.25 cm 07440 Excision of malignant tumor—lesion diameter up to 1.25 cm 07441 Excision of malignant tumor—lesion diameter over 1.25 cm 07450 Removal of odontogenic cyst or tumor—lesion diameter up to 1.25 cm 07451 Removal of odontogenic cyst or tumor—lesion diameter over 1.25 cm 074 6 0 Removal of nonodontogenic cyst or tumor—lesion diameter up to 1.25 cm 07461 Removal of nonodontogenic cyst or tumor—lesion diameter over 1.25 cm 07465 Destruction of lesion(s) by physical methods: electrosurgery, chemotherapy, cryotherapy, or laser Excision of bone tissue 07470 Removal of exostosis—maxilla or mandible 07480 Partial ostectomy (guttering or saucerization) 07490 Radical resection of mandible with bone graft Surgical incision 07510 Incision and drainage of abscess—intraoral soft tissue 07520 Incision and drainage of abscess— extraoral soft tissue 07530 Removal of foreign body, skin, or subcutaneous areolar tissue 07540 Removal of reaction-producing foreign bodies—musculoskeletal system 07550 Sequestrectomy for osteomyelitis 07560 Maxillary sinusotomy for removal of tooth fragment or foreign body Treatment of fractures—simple 07610 Maxilla—open reduction (teeth immobilized if present) 07620 Maxilla—closed reduction (teeth immobilized if present) 07630 Mandible— open reduction (teeth immobilized if present) 07640 Mandible— closed reduction (teeth immobilized if present) 07650 Malar and/or zygomatic arch—open reduction 07660 Malar and/or zygomatic arch—closed reduction 07670 Alveolus— stabilization of teeth, open reduction splinting 07680 Facial bones— complicated reduction with fixation and multiple surgical approaches Treatment of fractures—compound 07710 Maxilla—open reduction 07720 Maxilla—closed reduction 07730 Mandible— open reduction 07740 Mandible— closed reduction 07750 Malar and/or zygomatic arch—open reduction 392 ■ JADA, V ol. 110, M arch 1985
07760 Malar and/or zygomatic arch— closed reduction 07770 Alveolus— stabilization of teeth, open reduction splinting 07780 Facial bones— complicated reduction with fixation and multiple surgical approaches Reduction of dislocation and management of other temporomandibular joint dysfunctions 07810 Open reduction of dislocation 07820 Closed reduction of dislocation 07830 Manipulation under anesthesia 07840 Condylectomy 07850 Menisectomy 07860 Arthrotomy 07870 Arthrocentesis 07880 Occlusal orthotic appliance Repair of traum atic wounds 07910 Suture of recent small wounds up to 5 cm Complicated suturing (reconstruction requiring delicate handling of tissues and wide undermining for meticulous closure) 07911 Suture— up to 5 cm 07912 Suture— over 5 cm Other repair procedures 07920 Skin grafts (identify defect covered, location, and type of graft) 07940 Osteoplasty—for orthognathic deformities 07941 Osteotomy—ramus, closed 07942 Osteotomy—ramus, open 07943 Osteotomy—ramus, open with bone graft 07944 Osteotomy—segmented or subapical— per sextant or quadrant 07945 Osteotomy—body of mandible 07946 LeFort I (maxilla—total) 07947 LeFort I (maxilla—segmented) 07948 LeFort II or LeFort III (osteoplasty of facial bones for midface hypoplasia or retrusion)—without bone graft 07949 LeFort n or LeFort HI— with bone graft 07950 Osseous, osteoperiosteal, periosteal, or cartilage graft of the mandible— autogeneous or nonautogeneous 07955 Repair of maxillofacial soft and hard tissue defects 07960 Frenulectomy (frenectomy or frenotomy)— separate procedure 07970 Excision of hyperplastic tissue— per arch 07971 Excision of pericoronal gingiva 07980 Sialolithotomy 07981 Excision of salivary gland 07982 Sialodochoplasty 07983 Closure of salivary fistula 07990 Emergency tracheotomy 07991 Coronoidectomy 07992 Eminenectomy 07993 Implant—facial bones (homologous, heterologous, or alloplastic) 07994 Implant—chin (homologous, heterologous, or alloplastic) 07999 Unspecified oral surgery procedure, by report 08000-08999 X . Orthodontics M inor treatm ent for tooth guidance 08110 Removable appliance therapy 08120 Fixed appliance therapy M inor treatm ent to control harmful habits 08210 Removable appliance therapy 08220 Fixed appliance therapy Interceptive orthodontic treatment 08360 Removable appliance therapy 08370 Fixed appliance therapy
Comprehensive orthodontic treatment—transitional dentition 08460 Class I malocclusion 08470 Class II malocclusion 08480 Class III malocclusion Comprehensive orthodontic treatment—permanent dentition 08560 Class I malocclusion 08570 Class II malocclusion 08580 Class m malocclusion Other orthodontic services 08650 Treatment of the atypical or extended skeletal case 08750 Posttreatment stabilization 08999 Unspecified orthodontic procedure, by report 09000-09999 XI. Adjunctive general services Unclassified treatm ent 09110 Palliative (emergency) treatment of dental pain—minor procedures Anesthesia 09210 Local anesthesia not in conjunction with operative or surgical procedures 09211, Regional block anesthesia 09212 Trigeminal division block anesthesia 09215 Local anesthesia 09220 General anesthesia 09230 Analgesia 09240 Intravenous sedation Professional consultation (diagnostic service provided by dentist or physician other than practitioner providing treatment) 09310 Consultation— per session Professional visits 09410 House call 09420 Hospital call 09430 Office visit for observation (during regularly scheduled hours)— no other services performed 09440 Office visit— after regularly scheduled hours Drugs 09610 Therapeutic drug injection, by report 09630 Other drugs and/or medicaments, by report Miscellaneous services 09910 Application of desensitizing medicaments 09920 Behavior management, by report 09930 Treatment of complications (postsurgical)— unusual circumstances, by report 09940 Occlusal guards, by report 09941 Fabrication of athletic mouthguards 09950 Occlusion analysis— mounted case 09951 Occlusal adjustment— limited 09952 Occlusal adjustment— complete 09960 Completion of claim form 09999 Unspecified adjunctive procedure, by report
Codes for most frequently reported dental procedures 00100-00999 I. Diagnostic Clinical 00110 00120 00130
oral examinations Initial oral examination Periodic oral examination Emergency oral examination
Radiographs 00210 Intraoral— complete series (including bitewings) 00220 Intraoral—periapical— first film 00230 Intraoral—periapical— each additional film
A S S O C IA T IO N
00272 Bitewings— two films 00274 Bitewings—four films 00320 Temporomandibular joint arthrogram, including injection 00321 Other temporomandibular joint films, by report 00330 Panoramic film 00470 Diagnostic casts 01000-01999 II. Preventive Dental prophylaxis 01110 Adult 01120 Child Topical fluoride treatment (office procedure) 01201 Topical application of fluoride (including prophylaxis]— child 01202 Topical application of fluoride (including prophylaxis)— adult 01203 Topical application of fluoride (excluding prophylaxis)— child 01204 Topical application of fluoride (excluding prophylaxis)— adult Space maintenance (passive appliances) 01510 Space maintainer—fixed— unilateral 02000-02999 III. Restorative Amalgam restorations (including polishing) 02110 Amalgam— one surface, primary 02120 Amalgam—two surfaces, primary 02130 Amalgam—three surfaces, primary 02140 Amalgam— one surface, permanent 02150 Amalgam—two surfaces, permanent 02160 Amalgam—three surfaces, permanent 02161 Amalgam—four or more surfaces, permanent Silicate restorations 02210 Silicate cement—per restoration Filled or unfilled resin restorations 02330 Resin— one surface 02331 Resin—two surfaces 02332 Resin—three surfaces 02335 Resin—four or more surfaces or involving incisal angle Inlay restorations 02510 Inlay—metallic— one surface 02520 Inlay—metallic—two surfaces 02530 Inlay—metallic—three surfaces 02540 Onlay—metallic— per tooth (in addition to inlay) Crowns— single restoration only 02720 Crown—resin with high noble metal 02740 Crown—porcelain/ceramic substrate 02750 Crown—porcelain fused to high noble metal 02751 Crown— porcelain fused to predominantly base metal 02752 Crown—porcelain fused to noble metal 02790 Crown—full cast high noble metal 02810 Crown—% cast metallic
Pulpotomy 03 2 2 0 Therapeutic pulpotomy (excluding final restoration) Root can al therapy (including treatment plan, clinical procedures, and follow-up care) 03310 One canal (excluding final restoration) 03320 Two canals (excluding final restoration) 03330 Three canals (excluding final restoration) Periapical services 03 4 1 0 Apicoectomy (per tooth)— first root 03411 Apicoectomy (per tooth)— each additional root 04000-04999 V. Periodontics Surgical services (including usual postoperative services) 04 2 1 0 Gingivectomy or gingivoplasty— per quadrant 04211 Gingivectomy or gingivoplasty—per tooth 042 2 0 Gingival curettage, by report 0 4 2 6 0 Osseous surgery (including flap entry and closure)— per quadrant Adjunctive periodontal services 04321 Provisional splinting— extracoronal 043 4 0 Root planing— entire mouth 04341 Root planing—per quadrant 05000-05999 VL Prosthodontics (removable) Complete dentures (including routine postdelivery care) 051 1 0 Complete upper 05 1 2 0 Complete lower 05 1 3 0 Immediate upper 05140 Immediate lower Partial dentures (including routine postdelivery care) 05211 Upper partial— acrylic base (including any conventional clasps and rests) 05212 Lower partial— acrylic base (including any conventional clasps and rests) 05213 Upper partial— predominantly base cast base with acrylic saddles (including any conventional clasps and rests) 05214 Lower partial— predominantly base cast base with acrylic saddles (including any conventional clasps and rests) Repairs to complete dentures 05 5 1 0 Repair broken complete denture base 05 5 2 0 Replace missing or broken teeth— complete denture (each tooth) Repairs to partial dentures 05 6 1 0 Repair acrylic saddle or base 05 6 2 0 Repair cast framework 05 6 3 0 Repair or replace broken clasp 05 6 4 0 Replace broken teeth—per tooth 05 6 5 0 Add tooth to existing partial denture
REPO RTS
05660 Add clasp to existing partial denture Denture 05730 05731 05750 05751
reline procedures Reline complete upper denture (chairside) Reline complete lower denture (chairside) Reline complete upper denture (laboratory) Reline complete lower denture (laboratory)
06000-06999 VII. Prosthodontics, fixed (Each abutment and each pontic constitutes a unit in a bridge) Bridge pontics 06210 Pontic— cast high noble metal 06240 Pontic—porcelain fused to high noble metal 06250 Pontic—resin w ith high noble metal Retainers 06545 Cast m etal retainer for a d d etch bridge Bridge retainers— crowns 06720 Crown—resin with high noble metal 06750 Crown—porcelain fused to high noble metal 06780 Crown—% cast high noble metal 06790 Crown—full cast high noble metal Other fixed prosthetic services 06930 Recement bridge 06980 Bridge repair, by report 07000-07999 IX. Oral surgery Extractions—includes local anesthesia and routine postoperative care 07110 Single tooth 07120 Each additional tooth Surgical extractions—includes local anesthesia and routine postoperative care 07210 Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth 07220 Removal of impacted tooth— soft tissue 07230 Removal of impacted tooth— partially bony 07240 Removal of impacted tooth— completely bony 07241 Removal of impacted tooth— completely bony, with unusual surgical complications 07250 Surgical removal of residual tooth roots (cutting procedure} Alveoloplasty—surgical preparation of ridge for dentures 07310 Alveoloplasty in conjunction with extractions— per quadrant 09000-09999 XI. Adjunctive general services Unclassified treatm ent 09110 Palliative (emergency) treatment of dental pain—minor procedures Anesthesia 09220 General anesthesia 09230 Analgesia
Other restorative services 02910 Recement inlay 02920 Recement crown 02930 Prefabricated stainless steel crown—primary tooth 02931 Prefabricated stainless steel crown—permanent tooth 02940 Sedative filling 02952 Cast post and core in addition to crown 02953 Cast post as part of crown 02960 Labial veneer (laminate)
*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 Predominantly noble Noble base Classification alloy alloy alloy
03000-03999 IV. Endodontics
Weight %
Pulp capping 03110 Pulp cap— direct (excluding final restoration)
Au, Pd, and/or Pt ;* 60% (with at least 40% Au)
Au, Pd, and/or Pt 5 25%
Au, Pd, and/or Pt < 25%
JADA, Vol. 110, March 1985 ■ 393
tivities is that, in general, older people retain activity patterns and preferences developed earlier in life. If people are not participating in these activities during the middle years, why r exp ect them to begin in retirem ent? This suggests that leisure competence should be learned early in life. Doing so may be the only way to ensure leisure com petence in later life. In mentioning preparation for retirement, den tists tended to emphasize finances, health, and psychologic readiness. Few, if any, dentists suggested preparing for a life of leisure as a y component of preparation for retirement.
Sum m ary
This paper reports on the results of a national survey of retired dentists carried out in the winter and spring of 1984. More than eight in ten of the respondents were general practitio ners. Most retirees are between the ages of 60 and 69, married, and report their overall health at retirement to be excellent or good. As do retired s c ie n tists , d en tists find in trin s ic gratification in the work role, but apparently accept retirement as part of the life cycle. Re tired d en tists have in com e su b sta n tia lly greater than retirees in general. As is the case ■* for the greater majority of older Americans, Social Security provides an important income i support for respondent dentists. However, the ^ primary source of retirement incom e for den| tists comes from savings and investments. One I of three retired dentists reports net worth in I 1984 as between $200-$499,999. I Retired dentists are well adjusted to retire ment. Overall, most dentists report high satis faction with retirement to date. Additional lei
sure time for hobbies, flexibility in owning one’s time, and social activities with family and friends seem the main contributors to this satisfaction. Investment planning, health as sessment, enthusiasm for outside interests, and personal preparation for retirement with a spouse are reported as important in retirement planning. Retirement is not a satisfying experience for a ll dentists. Som e do report experiencing uselessness and depression. A still smaller proportion report feelings of loneliness and inadequacy. As is the case for older people in general, solitary activities including reading, watching television, and gardening are important for re tired dentists. Most older people attempt to re tain activ ity patterns and preferences de veloped earlier in life. By action, if not words, retired dentists seem to be recommending to their younger counterparts that preparation for a life of leisure be a component of preparation for retirement.
_________________________________ J£ O A \ T h is rep o rt w as approved by th e c o u n c il in November 1984.
Dr. Jackson is a pedodontist and financial planner, Charleston, SC; Dr. Kart is chairman, department of sociology, anthropology, and social work, University of Toledo, Toledo, OH; Ms. Wagner is head, survey operations, American Dental Association, Bureau of Econom ic and Behavioral Research; and Dr. Rowe is research consultant, Health Science Center, San An tonio, University of Texas. Address requests for re prints to the council, 211 E Chicago Ave, Chicago, 60611.
REPORTS
1. Bureau of Econom ic and Behavioral Research, Am erican Dental Association, 1982 distribution of dentists in the United States by region and state. 2. Siegel, J. Demographic aspects of aging and the older population in the US. Washington, DC, U S De partment of Commerce, Bureau of the Census, CPR, Series P-23, no. 59, 1976. 3. Com parison based on data from th e Health Interview Survey, National Center for Health Statis t ic s , D iv is io n o f H e a lth In te rv ie w S t a t i s t i c s , Rockville, MD, 1976. 4. Bureau of the Census. M oney incom e and pov erty status of fam ilies and persons in the U S: 1982. Washington, DC, US Department o f Commerce, CPR, Series P-60, no. 140, 1983. 5. Grad, S. Income of the population 55 and over. Washington, DC, Social Secu rity A dm inistration, 1983. 6. Brotman, H. The aging of Am erica: a demo graphic profile. National J, p 1626, Oct 7, 1978. 7. Kart, C. The realities of aging, ed 2. Boston, Allyn & Bacon, 1985. 8. Beck, S. Adjustm ent to and satisfaction with retirement. J Gerontology 37(5):616-624, 1982. 9. Patton, C. Early retirement in academ ia: making the decision. Gerontologist 17(4):347-354, 1977. 10. M iller, S. T he social dilem m as of the aging leisure participant. In Rose, A., and Peterson, W .,eds. Older people and their social world. Philadelphia, F.A. Davis, 1965. 11. Atchley, R. Retirement and leisure participa tion: continuity or crisis? Gerontologist 11:13-17, 1971. 12. Ellison, D. Work retirem ent and the sick role. Gerontologist 8:189-192, 1968. 13. Snow, A., and Havighurst, R. Life style types and patterns of retirem ent of educators. Gerontologist 17(6):545-552, 1977. 14. Riley, M., and Foner, A. Aging and society. Vol 1— An inventory of research findings. New York, Russell Sage Foundation, 1968. 15. Rowe, A.R. Scientists in retirement. J Gerontol 28:345-350, 1973.
r
Code on dental procedures and nomenclature
Council on Dental Care Programs The fifth revision of the Code on Dental Proce dures and Nomenclature is the result of several years of research and negotiations with insur’ ance industry representatives. The Code origi nally was developed and published in The Journal in 1969. Subsequent revisions were published in 1972 (JADA 85(4):789-792,1972); 1976 (JADA 92(3):647-652, 1976); and 1982 (JADA 104(3):351-356, 1982). In 1979, the Council com piled the Codes f o r Most Fre q u e n tly Reported D ental Procedures, a con' densed version for use as an easy reference for the dental office staff (JADA 9 8 (l):7 9 -8 0 ,1979). The com pilation contained several procedure codes that differed from the 1976 version, and the prefatory text noted that the wording in the more recent document took precedence. As with previous revisions, this latest ver
sion of the Code was developed in cooperation with practicing dentists throughout the United States, n atio n al dental organizations, the Health Insu rance A ssociation of A m erica, Delta Dental Plans Association, and Blue Cross and Blue Shield Associations. Copies of the Code are available from the Council.
Procedures covered Although the Code includes primarily the den tal services most frequently provided in a den tal office, it also lists dental services that are performed in hospitals. Diagnostic services common to most categories of treatment are grouped and listed generally in the sequence of treatment. To avoid duplication, other proce dures that are performed by general practitio ners and specialists alike have been grouped
under the specialty category with w hich the procedures are most frequently identified. The groupings according to specialty categories are solely for convenience in using the Code and should not be interpreted as excluding general practitioners from perform ing such proce dures. The purpose of these codes and nom encla ture is to facilitate the com pletion of dental prepayment claims in the dental office and processing in the claims office. The inclusion of a procedure in the Code provides only a means of reporting that procedure and has no effect on the terms of dental benefit contracts. Any dentist who finds that the nom enclature contained in this document does not accu rately describe a procedure should not use that code, but should instead provide a narrative report. JADA, Vol. 110, M arch 1985 ■ 389
A S S O C IA T IO N
REPORTS
The procedures included in the Code for Most Frequently Reported Dental Procedures are the procedures most often benefited under dental plans, and therefore remain the princi pal administrative aid to most dentists and their office staffs. It is printed here for conven ient reference.
Coding system The Code is a five-digit system to identify den tal procedures and services. The basic categories are: Category of service I II m IV V VI * VII
vm IX X XI
Diagnostic Preventive Restorative Endodontics Periodontics Prosthodontics, removable Maxillofacial prosthetics Prosthodontics, fixed Oral surgery Orthodontics Adjunctive general services
Code series
00100-00999 01000-01999 02000-02999 03000-03999 04000-04999 05000-05899 05900-05999 06000-06999 07000-07999 08000-08999 09000-09999
00100-00999 I. Diagnostic Clinical oral examinations 00110 Initial oral examination 00120 Periodic oral examination 00130 Emergency oral examination Radiographs 00210 Intraoral— complete series (including bitewings) 00220 Intraoral— periapical—first film 00230 Intraoral— periapical—each additional film 00240 Intraoral-occlusal film 00250 Extraoral— first film 00260 Extraoral— each additional film 00270 Bitewing— single film 00272 Bitewings—two films 00274 Bitewings— four films 00275 Bitewings— each additional film 00290 Posteroanterior and lateral skull and facial bone, survey film 00310 Saliography 00320 Temporomandibular joint arthrogram, including injection 00321 Other temporomandibular joint films, by report 00330 Panoramic film 00340 Cephalometric film Tests and laboratory examinations 00410 Bacteriologic studies for determination of pathologic agents 00420 Caries susceptibility tests 00460 Pulp vitality tests 00470 Diagnostic casts 00471 Diagnostic photographs 00501 Histopathologic examinations 00502 Other oral pathology procedures, by report 00999 Unspecified diagnostic procedure, by report 01000-01999 Q. Preventive Dental prophylaxis OHIO Prophylaxis— adult 01120 Prophylaxis— child 390 ■ JADA, V o l. 110, M arch 1985
T opical fluoride treatment (office procedure) 01201 Topical application of fluoride (including prophylaxis)— child 01202 Topical application of fluoride (including prophylaxis)— adult 01203 Topical application of fluoride (excluding prophylaxis)— child 01204 Topical application of fluoride (excluding prophylaxis)— adult Other preventive services 013 1 0 Dietary planning for the control of dental caries 01330 Oral hygiene instruction 01351 Sealant— per tooth Space m aintenance (passive appliances) 01510 Space maintainer—fixed—unilateral 01515 Space maintainer—fixed—bilateral 01520 Space maintainer— removable— unilateral 01525 Space maintainer—removable—bilateral 01550 Recementation of space maintainer 02000-02999 IH. Restorative Amalgam restorations (including polishing) 02 1 1 0 Amalgam—one surface, primary 02120 Amalgam—two surfaces, primary 02130 Amalgam—three surfaces, primary 02131 Amalgam—four surfaces, primary 02140 Amalgam— one surface, permanent 021-50 Amalgam—two surfaces, permanent 02160 Amalgam—three surfaces, permanent 02161 Amalgam—four or more surfaces, permanent Silicate restorations 02 2 1 0 Silicate cement—per restoration Filled or unfilled resin restorations 02330 Resin— one surface 02331 Resin— two surfaces 02332 Resin— three surfaces 02335 Resin— four or more surfaces or involving incisal angle Gold foil restorations 02410 Gold foil— one surface 02420 Gold foil—two surfaces 02430 Gold foil—three surfaces Inlay restorations 02510 Inlay— metallic—one surface 02520 Inlay— metallic—two surfaces 025 3 0 Inlay— metallic—three surfaces 025 4 0 Onlay—metallic—per tooth (in addition to inlay) 026 1 0 Inlay— porcelain/ceramic—one surface 02620 Inlay— porcelain/ceramic—two surfaces 02630 Inlay— porcelain/ceramic—three surfaces Crowns—single restoration only 02710 Crown— resin (laboratory) 02720 Crown—resin with high noble metal 02721 Crown—resin with predominantly base metal 02722 Crown—resin with noble metal 02740 Crown— porcelain/ceramic substrate 02750 Crown— porcelain fused to high noble metal 02751 Crown— porcelain fused to predominantly base metal 02752 Crown— porcelain fused to noble metal 02790 Crown—full cast high noble metal 02791 Crown—full cast predominantly base metal 02792 Crown— full cast noble metal 02810 Crown— % cast metallic Other restorative services 02910 Recement inlay 02920 Recement crown 02930 Prefabricated stainless steel crown— primary tooth
02931 Prefabricated stainless steel crown— permanent tooth 02932 Prefabricated resin crown 02940 Sedative filling 02 9 5 0 Crown buildup, including any pins 02951 Pin retention—per tooth, in addition to restoration 02952 Cast post and core in addition to crown 02953 Cast post as part of crown 02954 Prefabricated post and core in addition to crown 02960 Labial veneer (laminate) 02970 Temporary (fractured tooth) 02980 Crown repair, by report 02999 Unspecified restorative procedure, by report 03000-03999 IV. Endodontics Pulp capping 03110 Pulp cap— direct (excluding final restoration) 03120 Pulp cap— indirect (excluding final restoration) Pulpotomy 03220 Therapeutic pulpotomy (excluding final restoration) Root canal therapy (including treatment plan, clinical procedures, and follow-up care) 03310 One canal (excluding final restoration) 03320 Two canals (excluding final restoration) 03330 Three canals (excluding final restoration) 03340 Four or more canals (excluding final restoration) 03350 Apexification (per treatment visit) Periapical services 03410 Apicoectomy (per tooth)— first root 03411 Apicoectomy (per tooth)— each additional root 03430 Retrograde filling— per root 03440 Apical curettage 03450 Root amputation—per root 03460 Endodontic endosseous implant Other endodontic procedures 03910 Surgical procedure for isolation of tooth with rubber dam 03920 Hemisection (including any root removal), not including root canal therapy 03940 Recalcification or repair (perforations, root resorption, etc) 03950 Canal preparation and fitting of preformed dowel or post 03960 Bleaching of discolored tooth 03999 Unspecified endodontic procedure, by report 04000-04999 V. Periodontics Surgical services (including usual postoperative services) 04210 Gingivectomy or gingivoplasty— per quadrant 04211 Gingivectomy or gingivoplasty—per tooth 04220 Gingival curettage, by report 04240 Gingival flap curettage (including root planing) 04260 Osseous surgery (including flap entry and closure)— per quadrant 04261 Osseous graft—single site (including flap entry, closure, and donor site) 04262 Osseous graft—multiple sites (including flap entry, closure, and donor sites) 04270 Pedicle soft tissue graft procedure 04271 Free soft tissue graft procedure (including donor site) 04272 Apically repositioning flap procedure
A S S O C IA T IO N
Adjunctive periodontal services 04320 Provisional splinting— intracoronal 04321 Provisional splinting— extracoronal 04340 Root planing— entire mouth 04341 Root planing—per quadrant Other periodontal services 04910 Periodontal maintenance procedures following active therapy (periodontal prophylaxis) 04920 Unscheduled dressing change (by someone other than treating dentist) 04999 Unspecified periodontal procedure, by report 05000-05999 VI. Prosthodontics (removable) Complete dentures (including routine postdelivery care) 05110 Complete upper 05120 Complete lower 05130 Immediate upper 05140 Immediate lower Partial dentures (including routine postdelivery care) 05211 Upper partial—acrylic base (including any conventional clasps and rests) 05212 Lower partial— acrylic base (including any conventional clasps and rests) 05213 Upper partial— predominantly base cast base with acrylic saddles (including any conventional clasps and rests) 05214 Lower partial— predominantly base cast base w ith acrylic saddles (including any conventional clasps and rests) 05215 Upper partial—high noble cast base with acrylic saddles (including any conventional clasps and rests) 05216 Lower partial— high noble cast base with acrylic saddles (including any conventional clasps and rests) 052 80 Removable unilateral partial denture— one piece high noble casting, clasp attachments— per unit (including pontics) 05281 Removable unilateral partial denture— one piece predominantly base casting, clasp attachments— per unit (including pontics) Adjustments to dentures 05410 Adjust complete denture—upper 05411 Adjust complete denture—lower 05421 Adjust partial denture— upper 05422 Adjust partial denture— lower Repairs to com plete dentures 05510 Repair broken complete denture base 05520 Replace missing or broken teeth— complete denture (each tooth) Repairs to partial dentures 05610 Repair acrylic saddle or base 05620 Repair cast framework 05630 Repair or replace broken clasp 05640 Replace broken teeth—per tooth 05650 Add tooth to existing partial denture 05660 Add clasp to existing partial denture Denture 05710 05711 05720 05721
rebase procedures Rebase complete upper denture Rebase complete lower denture Rebase upper partial denture Rebase lower partial denture
Denture 05730 05731 05740 05741 05750 05751 05760
reline procedures Reline upper complete denture (chairside) Reline lower complete denture (chairside) Reline upper partial denture (chairside) Reline lower partial denture (chairside) Reline upper complete denture (laboratory) Reline lower complete denture (laboratory) Reline upper partial denture (laboratory)
05761 Reline lower partial denture (laboratory) Other removable prosthetic services 058 1 0 Temporary complete denture (upper) 05811 Temporary complete denture (lower) 05 8 2 0 Temporary partial— stayplate denture (upper) 05821 Temporary partial— stayplate denture (lower) 05 8 5 0 Tissue conditioning— per denture unit 05 8 6 0 Overdenture— complete, by report 05861 Overdenture— partial, by report 05862 Precision attachment, by report 05 8 9 9 Unspecified removable prosthodontic procedure, by report 0 5900-05999 VII. M axillofacial prosthetics E xtraoral prostheses (including three months’ maintenance) 05911 Facial moulage (sectional) 05912 Facial moulage (complete) 05913 Nasal prosthesis 05 9 1 4 Auricular prosthesis 05915 Orbital prosthesis 05 9 1 6 Ocular prosthesis 05 9 1 7 Composite facial prosthesis 05918 Replacement prosthesis 05919 Prosthetic dressing 05 9 2 0 Ocular implant 05921 Orbital implant Intraoral prostheses—acquired defects 05931 Surgical obturator 05932 Postsurgical obturator 05933 Refitting of obturator 05934 Mandibular resection (flange) prosthesis 0 5 9 3 5 Mandibular resection (denture) prosthesis Intraoral prostheses— congenital defects 05951 Feeding aid 05952 Pediatric speech aid 05953 Adult speech aid 0 5 9 5 4 Superimposed prosthesis 05955 Palatal lift prosthesis 0 5 9 5 6 Obturator 05 9 5 7 Speech bulb Implants—facial, mandibular, cranial 05971 Simple implant 05972 Complex implant 05973 Subperiostial implant 05974 Endosseous implant (in the bone) 05976 Mandibular staple implant Treatm ent prostheses 05982 Surgical stent 05983 Radiation carrier 05984 Radiation shield 05985 Docking device— cone locator 0 5 9 8 6 Fluoride applicator—per arch 0 5 9 9 9 Unspecified maxillofacial prosthesis, by report 06000-06999 VII. Prosthodontics, fixed (Each abutment and each pontic constitutes a unit in a bridge.) Bridge pontics 06210 Pontic— cast high noble metal 06211 Pontic— cast predominantly base metal 06212 Pontic— cast noble metal 06 2 4 0 Pontic—porcelain fused to high noble metal 06241 Pontic— porcelain fused to predominantly base metal 06242 Pontic— porcelain fused to noble metal 0 6 2 5 0 Pontic— resin with high noble metal 06251 Pontic— resin with predominantly base metal 06252 Pontic—resin with noble metal Retainers 065 2 0 Inlay—metallic—two surfaces
REPORTS
06530 Inlay—metallic—three or more surfaces 06540 Inlay—metallic— onlaying cusps 06545 Cast metal retainer for acid etch bridge Bridge retainers—crowns 06720 Crown—resin with high noble metal 06721 Crown—resin with predominantly base metal 06722 Crown—resin with noble metal 06750 Crown— porcelain fused to high noble metal 06751 Crown— porcelain fused to predominantly base metal 06752 Crown—porcelain fused to noble metal 06780 Crown—% cast high noble metal 06790 Crown—full cast high noble metal 06791 Crown—full cast predominantly base metal 06792 Crown— full cast noble metal Other fixed prosthetic services 06930 Recement bridge 06940 Stress breaker 06950 Precision attachment 06970 Cast post and core in addition to bridge retainer 06971 Cast post as part of bridge retainer 06972 Prefabricated post and core in addition to bridge retainer 06980 Bridge repair, by report 06999 Unspecified fixed prosthodontic procedure, by report 0 7000-07999 IX. Oral surgery Extractions—includes local anesthesia and routine postoperative care 07110 Single tooth 07120 Each additional tooth 07130 Root removal— exposed roots Surgical extractions— includes local anesthesia and routine postoperative care 07210 Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth 07220 Removal of impacted tooth—soft tissue 07230 Removal of impacted tooth—partially bony 07240 Removal of impacted tooth— completely bony 07241 Removal of impacted tooth— completely bony, with unusual surgical complications 07250 Surgical removal of residual tooth roots (cutting procedure) Other surgical procedures 07260 Oroantral fistula closure 07270 Tooth re-implantation and/or stabilization of accidentally evulsed or displaced tooth and/or alveolus 07271 Tooth implantation 07272 Tooth transplantation 07280 Surgical exposure of impacted or unerupted tooth for orthodontic reasons (including orthodontic attachments) 07281 Surgical exposure of impacted or unerupted tooth to aid eruption 07285 Biopsy of oral tissue—hard 07286 Biopsy of oral tissue— soft 07290 Surgical repositioning of teeth 07291 Transseptal fiberotomy Alveoloplasty— surgical preparation of ridge for dentures 07310 Alveoloplasty in conjunction with extractions— per quadrant 07320 Alveoloplasty not in conjunction with extractions— per quadrant Vestibuloplasty 07340 Vestibuloplasty—ridge extension (secondary epithelialization) JADA, V ol. 110, M arch 1985 ■ 391
A S S O C IA T IO N
REPORTS
07350 Vestibuloplasty—ridge extension (including soft tissue grafts, muscle re-attachments, revision of soft tissue attachment, and management of hypertrophied and hyperplastic tissue) Surgical excision o f reactive inflammatory lesions (scar tissue or localized congenital lesions) 07410 Radical excision—lesion diameter up to 1.25 cm 07420 Radical excision—lesion diameter over 1.25 cm Removal of tumors, cysts, and neoplasms 07430 Excision of benign tumor—lesion diameter up to 1.25 cm 07431 Excision of benign tumor— lesion diameter over 1.25 cm 07440 Excision of malignant tumor—lesion diameter up to 1.25 cm 07441 Excision of malignant tumor—lesion diameter over 1.25 cm 07450 Removal of odontogenic cyst or tumor—lesion diameter up to 1.25 cm 07451 Removal of odontogenic cyst or tumor—lesion diameter over 1.25 cm 074 6 0 Removal of nonodontogenic cyst or tumor—lesion diameter up to 1.25 cm 07461 Removal of nonodontogenic cyst or tumor—lesion diameter over 1.25 cm 07465 Destruction of lesion(s) by physical methods: electrosurgery, chemotherapy, cryotherapy, or laser Excision of bone tissue 07470 Removal of exostosis—maxilla or mandible 07480 Partial ostectomy (guttering or saucerization) 07490 Radical resection of mandible with bone graft Surgical incision 07510 Incision and drainage of abscess—intraoral soft tissue 07520 Incision and drainage of abscess— extraoral soft tissue 07530 Removal of foreign body, skin, or subcutaneous areolar tissue 07540 Removal of reaction-producing foreign bodies—musculoskeletal system 07550 Sequestrectomy for osteomyelitis 07560 Maxillary sinusotomy for removal of tooth fragment or foreign body Treatment of fractures—simple 07610 Maxilla—open reduction (teeth immobilized if present) 07620 Maxilla—closed reduction (teeth immobilized if present) 07630 Mandible— open reduction (teeth immobilized if present) 07640 Mandible— closed reduction (teeth immobilized if present) 07650 Malar and/or zygomatic arch—open reduction 07660 Malar and/or zygomatic arch—closed reduction 07670 Alveolus— stabilization of teeth, open reduction splinting 07680 Facial bones— complicated reduction with fixation and multiple surgical approaches Treatment of fractures—compound 07710 Maxilla—open reduction 07720 Maxilla—closed reduction 07730 Mandible— open reduction 07740 Mandible— closed reduction 07750 Malar and/or zygomatic arch—open reduction 392 ■ JADA, V ol. 110, M arch 1985
07760 Malar and/or zygomatic arch— closed reduction 07770 Alveolus— stabilization of teeth, open reduction splinting 07780 Facial bones— complicated reduction with fixation and multiple surgical approaches Reduction of dislocation and management of other temporomandibular joint dysfunctions 07810 Open reduction of dislocation 07820 Closed reduction of dislocation 07830 Manipulation under anesthesia 07840 Condylectomy 07850 Menisectomy 07860 Arthrotomy 07870 Arthrocentesis 07880 Occlusal orthotic appliance Repair of traum atic wounds 07910 Suture of recent small wounds up to 5 cm Complicated suturing (reconstruction requiring delicate handling of tissues and wide undermining for meticulous closure) 07911 Suture— up to 5 cm 07912 Suture— over 5 cm Other repair procedures 07920 Skin grafts (identify defect covered, location, and type of graft) 07940 Osteoplasty—for orthognathic deformities 07941 Osteotomy—ramus, closed 07942 Osteotomy—ramus, open 07943 Osteotomy—ramus, open with bone graft 07944 Osteotomy—segmented or subapical— per sextant or quadrant 07945 Osteotomy—body of mandible 07946 LeFort I (maxilla—total) 07947 LeFort I (maxilla—segmented) 07948 LeFort II or LeFort III (osteoplasty of facial bones for midface hypoplasia or retrusion)—without bone graft 07949 LeFort n or LeFort HI— with bone graft 07950 Osseous, osteoperiosteal, periosteal, or cartilage graft of the mandible— autogeneous or nonautogeneous 07955 Repair of maxillofacial soft and hard tissue defects 07960 Frenulectomy (frenectomy or frenotomy)— separate procedure 07970 Excision of hyperplastic tissue— per arch 07971 Excision of pericoronal gingiva 07980 Sialolithotomy 07981 Excision of salivary gland 07982 Sialodochoplasty 07983 Closure of salivary fistula 07990 Emergency tracheotomy 07991 Coronoidectomy 07992 Eminenectomy 07993 Implant—facial bones (homologous, heterologous, or alloplastic) 07994 Implant—chin (homologous, heterologous, or alloplastic) 07999 Unspecified oral surgery procedure, by report 08000-08999 X . Orthodontics M inor treatm ent for tooth guidance 08110 Removable appliance therapy 08120 Fixed appliance therapy M inor treatm ent to control harmful habits 08210 Removable appliance therapy 08220 Fixed appliance therapy Interceptive orthodontic treatment 08360 Removable appliance therapy 08370 Fixed appliance therapy
Comprehensive orthodontic treatment—transitional dentition 08460 Class I malocclusion 08470 Class II malocclusion 08480 Class III malocclusion Comprehensive orthodontic treatment—permanent dentition 08560 Class I malocclusion 08570 Class II malocclusion 08580 Class m malocclusion Other orthodontic services 08650 Treatment of the atypical or extended skeletal case 08750 Posttreatment stabilization 08999 Unspecified orthodontic procedure, by report 09000-09999 XI. Adjunctive general services Unclassified treatm ent 09110 Palliative (emergency) treatment of dental pain—minor procedures Anesthesia 09210 Local anesthesia not in conjunction with operative or surgical procedures 09211, Regional block anesthesia 09212 Trigeminal division block anesthesia 09215 Local anesthesia 09220 General anesthesia 09230 Analgesia 09240 Intravenous sedation Professional consultation (diagnostic service provided by dentist or physician other than practitioner providing treatment) 09310 Consultation— per session Professional visits 09410 House call 09420 Hospital call 09430 Office visit for observation (during regularly scheduled hours)— no other services performed 09440 Office visit— after regularly scheduled hours Drugs 09610 Therapeutic drug injection, by report 09630 Other drugs and/or medicaments, by report Miscellaneous services 09910 Application of desensitizing medicaments 09920 Behavior management, by report 09930 Treatment of complications (postsurgical)— unusual circumstances, by report 09940 Occlusal guards, by report 09941 Fabrication of athletic mouthguards 09950 Occlusion analysis— mounted case 09951 Occlusal adjustment— limited 09952 Occlusal adjustment— complete 09960 Completion of claim form 09999 Unspecified adjunctive procedure, by report
Codes for most frequently reported dental procedures 00100-00999 I. Diagnostic Clinical 00110 00120 00130
oral examinations Initial oral examination Periodic oral examination Emergency oral examination
Radiographs 00210 Intraoral— complete series (including bitewings) 00220 Intraoral—periapical— first film 00230 Intraoral—periapical— each additional film
A S S O C IA T IO N
00272 Bitewings— two films 00274 Bitewings—four films 00320 Temporomandibular joint arthrogram, including injection 00321 Other temporomandibular joint films, by report 00330 Panoramic film 00470 Diagnostic casts 01000-01999 II. Preventive Dental prophylaxis 01110 Adult 01120 Child Topical fluoride treatment (office procedure) 01201 Topical application of fluoride (including prophylaxis]— child 01202 Topical application of fluoride (including prophylaxis)— adult 01203 Topical application of fluoride (excluding prophylaxis)— child 01204 Topical application of fluoride (excluding prophylaxis)— adult Space maintenance (passive appliances) 01510 Space maintainer—fixed— unilateral 02000-02999 III. Restorative Amalgam restorations (including polishing) 02110 Amalgam— one surface, primary 02120 Amalgam—two surfaces, primary 02130 Amalgam—three surfaces, primary 02140 Amalgam— one surface, permanent 02150 Amalgam—two surfaces, permanent 02160 Amalgam—three surfaces, permanent 02161 Amalgam—four or more surfaces, permanent Silicate restorations 02210 Silicate cement—per restoration Filled or unfilled resin restorations 02330 Resin— one surface 02331 Resin—two surfaces 02332 Resin—three surfaces 02335 Resin—four or more surfaces or involving incisal angle Inlay restorations 02510 Inlay—metallic— one surface 02520 Inlay—metallic—two surfaces 02530 Inlay—metallic—three surfaces 02540 Onlay—metallic— per tooth (in addition to inlay) Crowns— single restoration only 02720 Crown—resin with high noble metal 02740 Crown—porcelain/ceramic substrate 02750 Crown—porcelain fused to high noble metal 02751 Crown— porcelain fused to predominantly base metal 02752 Crown—porcelain fused to noble metal 02790 Crown—full cast high noble metal 02810 Crown—% cast metallic
Pulpotomy 03 2 2 0 Therapeutic pulpotomy (excluding final restoration) Root can al therapy (including treatment plan, clinical procedures, and follow-up care) 03310 One canal (excluding final restoration) 03320 Two canals (excluding final restoration) 03330 Three canals (excluding final restoration) Periapical services 03 4 1 0 Apicoectomy (per tooth)— first root 03411 Apicoectomy (per tooth)— each additional root 04000-04999 V. Periodontics Surgical services (including usual postoperative services) 04 2 1 0 Gingivectomy or gingivoplasty— per quadrant 04211 Gingivectomy or gingivoplasty—per tooth 042 2 0 Gingival curettage, by report 0 4 2 6 0 Osseous surgery (including flap entry and closure)— per quadrant Adjunctive periodontal services 04321 Provisional splinting— extracoronal 043 4 0 Root planing— entire mouth 04341 Root planing—per quadrant 05000-05999 VL Prosthodontics (removable) Complete dentures (including routine postdelivery care) 051 1 0 Complete upper 05 1 2 0 Complete lower 05 1 3 0 Immediate upper 05140 Immediate lower Partial dentures (including routine postdelivery care) 05211 Upper partial— acrylic base (including any conventional clasps and rests) 05212 Lower partial— acrylic base (including any conventional clasps and rests) 05213 Upper partial— predominantly base cast base with acrylic saddles (including any conventional clasps and rests) 05214 Lower partial— predominantly base cast base with acrylic saddles (including any conventional clasps and rests) Repairs to complete dentures 05 5 1 0 Repair broken complete denture base 05 5 2 0 Replace missing or broken teeth— complete denture (each tooth) Repairs to partial dentures 05 6 1 0 Repair acrylic saddle or base 05 6 2 0 Repair cast framework 05 6 3 0 Repair or replace broken clasp 05 6 4 0 Replace broken teeth—per tooth 05 6 5 0 Add tooth to existing partial denture
REPO RTS
05660 Add clasp to existing partial denture Denture 05730 05731 05750 05751
reline procedures Reline complete upper denture (chairside) Reline complete lower denture (chairside) Reline complete upper denture (laboratory) Reline complete lower denture (laboratory)
06000-06999 VII. Prosthodontics, fixed (Each abutment and each pontic constitutes a unit in a bridge) Bridge pontics 06210 Pontic— cast high noble metal 06240 Pontic—porcelain fused to high noble metal 06250 Pontic—resin w ith high noble metal Retainers 06545 Cast m etal retainer for a d d etch bridge Bridge retainers— crowns 06720 Crown—resin with high noble metal 06750 Crown—porcelain fused to high noble metal 06780 Crown—% cast high noble metal 06790 Crown—full cast high noble metal Other fixed prosthetic services 06930 Recement bridge 06980 Bridge repair, by report 07000-07999 IX. Oral surgery Extractions—includes local anesthesia and routine postoperative care 07110 Single tooth 07120 Each additional tooth Surgical extractions—includes local anesthesia and routine postoperative care 07210 Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap and removal of bone and/or section of tooth 07220 Removal of impacted tooth— soft tissue 07230 Removal of impacted tooth— partially bony 07240 Removal of impacted tooth— completely bony 07241 Removal of impacted tooth— completely bony, with unusual surgical complications 07250 Surgical removal of residual tooth roots (cutting procedure} Alveoloplasty—surgical preparation of ridge for dentures 07310 Alveoloplasty in conjunction with extractions— per quadrant 09000-09999 XI. Adjunctive general services Unclassified treatm ent 09110 Palliative (emergency) treatment of dental pain—minor procedures Anesthesia 09220 General anesthesia 09230 Analgesia
Other restorative services 02910 Recement inlay 02920 Recement crown 02930 Prefabricated stainless steel crown—primary tooth 02931 Prefabricated stainless steel crown—permanent tooth 02940 Sedative filling 02952 Cast post and core in addition to crown 02953 Cast post as part of crown 02960 Labial veneer (laminate)
*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 Predominantly noble Noble base Classification alloy alloy alloy
03000-03999 IV. Endodontics
Weight %
Pulp capping 03110 Pulp cap— direct (excluding final restoration)
Au, Pd, and/or Pt ;* 60% (with at least 40% Au)
Au, Pd, and/or Pt 5 25%
Au, Pd, and/or Pt < 25%
JADA, Vol. 110, March 1985 ■ 393