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Codes for most frequently reported dental procedures
Codes for most frequently reported dental procedures Council on Dental Care Programs
T ■ his list of the most frequently re ported dental procedures is intended as an easy reference for the dental office staff. The more comprehensive Code on Dental Procedures and Nomenclature, published in March 1976, remains in effect. In a few in stances, a comparison of this docu ment with the earlier Code on Dental Procedures and Nomenclature will show differences in descriptions of procedures related to particular code numbers. Where this occurs, the wording in this more recent docu
ment takes precedence. The list of the most frequently per formed procedures was developed by the Council on Dental Care Programs in cooperation with the Health Insur ance Association of America, Delta Dental Plans Association, and the Blue Cross and Blue Shield Associa tions. The purpose of these codes and nomenclature is to facilitate the completion of dental prepayment claims in the dental office and the processing of those claims in the
claims office. Neither the Code on Dental Procedures and Nomen clature (March 1976) nor the Codes for Most Frequently Reported Pro cedures is intended as a represen tation of the practice of dentistry or of any dental specialty. It is simply an administrative aid. Any dentist who finds that the nomenclature contained in these two documents does not accurately de scribe a procedure performed by him, should not use the code but should provide a narrative report instead.
CODES ON FOLLOWING PAGE
CODES FOR DENTAL PROCEDURES /JADA, Vol. 98, January 1979 ■ 79
A S S O C IA T IO N
REPO RTS
CODES FOR MOST FREQUENTLY REPORTED DENTAL PROCEDURES ADA Council on Dental Care Programs
00100-00999 Diagnostic 00110 Initial oral examination 00120 Periodic oral examination 00130 Emergency oral examination 00200 Radiographs 00210 Intraoral—complete series (including bite-wings) 00220 Intraoral periapical—single, first film 00230 Intraoral periapical—each additional film 00272 Bite-wing—two films 00274 Bite-wing—four films 00330 Panoramic—maxilla and mandible, film 00470 Diagnostic casts 01000-01999 Preventive 01100 Dental prophylaxis OHIO Adults 01120 Children 01200 Fluoride treatments 01201 Topical application of fluoride (includ ing prophylaxis]—children 01500 Space management therapy 01510 Fixed—unilateral type 02000-02999 Restorative 02100 Amalgam restorations (including polish ing) 02110 Amalgam—one surface, deciduous 02120 Amalgam—two surfaces, deciduous 02130 Amalgam—three surfaces, deciduous 02140 Amalgam—one surface, permanent 02150 Amalgam—two surfaces, permanent 02160 Amalgam—three surfaces, permanent 02161 Amalgam—four or more surfaces, per manent 02200 Silicate restorations 02210 Silicate cement per restoration 02300 Acrylic or plastic or composite restora tions 02310 Acrylic or plastic or composite resin 02335 Acrylic or plastic or composite resin (involving incisal angle) 02500 Gold inlay restorations 02520 Inlay—gold, two surfaces 02530 Inlay—gold, three surfaces 02540 Onlay—per tooth (in addition to forego ing) 02700-02899 Crowns—single restoration only 02720 Plastic with gold 02740 Porcelain 02750 Porcelain with gold 02790 Gold {full cast) 02810 Gold (3/4 cast) 02830 Prefabricated stainless steel—primary 02891 Cast post and core in addition to crown 02892 Prefabricated post and core in addition to crown 02900 Other restorative services 02920 Recement crowns
02940 Fillings (sedative) 02950 Crown buildup, pin retained 03000-03999 Endodontics 03100 Pulp capping 03110 Pulp cap—direct (excluding final resto ration) 03200 Pulpotomy (excluding final restoration) 03220 Vital pulpotomy 03300 Root canal therapy (includes treatment plan, clinical procedures, and follow-up care) 03310 Anterior (excludes final restoration) 03320 Bicuspid (excludes final restoration) 03330 Molar (excludes final restoration) 03400 Periapical services 03410 Apicoectomy—performed as separate surgical procedure (per root) 04000-04999 Periodontics 04210 Gingivectomy or gingivoplasty—per quadrant 04220 Gingival curettage—per quadrant 04260 Osseous surgery (including flap entry and closure)—per quadrant 04300 Adjunctive periodontal services (in con junction with total periodontal treatment) 04330 Occlusal adjustment (limited) 04331 Occlusal adjustment (complete) 04340 Periodontal scaling and root planing (entire mouth) 04341 Periodontal scaling and root planing— per quadrant 05000-05999 Prosthodontics, removable— including routine postdelivery care 05110 Complete upper 05120 Complete lower 05130 Immediate upper 05140 Immediate lower 05200 Partial dentures—including routine postdelivery care 05211 Upper, excluding clasps, acrylic base 05212 Lower, excluding clasps, acrylic base 05213 Upper—cast chrome base, with acrylic saddles, excluding clasps 05214 Lower—cast chrome base, with acrylic saddles, excluding clasps 05300 Additional units for partial dentures 05310 Each clasp with rest 05320 Each tooth 05600 Repairs to dentures 05610 Repair broken complete or partial denture— no teeth damaged 0562Q Repair broken complete or partial denture—replace one broken tooth 05630 Replace additional teeth—each tooth 05640 Replace broken tooth on denture—no other repairs 05650 Adding tooth to partial denture to re place extracted tooth—each tooth (not in volving clasp or abutment tooth)
80 ■ CODES FOR DENTAL PROCEDURES I JADA, Vol. 98, January 1979
05660 Adding tooth to partial denture to re place extracted tooth—each tooth (involving clasp or abutment tooth) Denture relining 05730 Relining upper or lower complete den ture (office reline) 05750 Relining upper or lower complete den ture (laboratory) 06000-06999 Prosthodontics, fixed 06200 Bridge pontics 06210 Cast gold 06240 Porcelain fused to gold 06250 Plastic processed to gold 06700 Crowns 06720 Plastic processed to gold 06750 Porcelain fused to gold 06780 Gold (3/4 cast) 06790 Gold (full cast) 06900 Other prosthetic services 06930 Recement bridge 07000-07999 Oral surgery 07100 Extractions—includes local anesthesia and routine postoperative care 07110 Single tooth 07120 Each additional tooth 07200 Surgical extractions—includes local anesthesia and routine postoperative care 07210 Surgical removal of erupted tooth, re quires elevation of mucoperiosteal flap and removal of bone and/or section of tooth 07220 Impaction that requires incision of overlying soft tissue and the removal of the tooth 07230 Impaction that requires incision of over lying soft tissue, elevation of a flap, and either removal of bone and tooth or section ing and removal of the tooth 0 7240 Impaction that requires incision of overlying soft tissue, elevation of a flap, removal of bone, and sectioning of the tooth for re moval 07250 Root recovery (surgical removal of re sidual root) 07300 Alveoloplasty (surgical preparation of ridge for dentures) 07310 Per quadrant—in conjunction with ex tractions 09000-09999 Adjunctive general services 09110 Palliative (emergency) treatment of den tal pain, minor procedures 09200 Anesthesia 09220 General 09300 Professional consultation—diagnostic service provided by physician or dentist other than practitioner providing treatment 09310 Consultation—per session
T ■ his list of the most frequently re ported dental procedures is intended as an easy reference for the dental office staff. The more comprehensive Code on Dental Procedures and Nomenclature, published in March 1976, remains in effect. In a few in stances, a comparison of this docu ment with the earlier Code on Dental Procedures and Nomenclature will show differences in descriptions of procedures related to particular code numbers. Where this occurs, the wording in this more recent docu
ment takes precedence. The list of the most frequently per formed procedures was developed by the Council on Dental Care Programs in cooperation with the Health Insur ance Association of America, Delta Dental Plans Association, and the Blue Cross and Blue Shield Associa tions. The purpose of these codes and nomenclature is to facilitate the completion of dental prepayment claims in the dental office and the processing of those claims in the
claims office. Neither the Code on Dental Procedures and Nomen clature (March 1976) nor the Codes for Most Frequently Reported Pro cedures is intended as a represen tation of the practice of dentistry or of any dental specialty. It is simply an administrative aid. Any dentist who finds that the nomenclature contained in these two documents does not accurately de scribe a procedure performed by him, should not use the code but should provide a narrative report instead.
CODES ON FOLLOWING PAGE
CODES FOR DENTAL PROCEDURES /JADA, Vol. 98, January 1979 ■ 79
A S S O C IA T IO N
REPO RTS
CODES FOR MOST FREQUENTLY REPORTED DENTAL PROCEDURES ADA Council on Dental Care Programs
00100-00999 Diagnostic 00110 Initial oral examination 00120 Periodic oral examination 00130 Emergency oral examination 00200 Radiographs 00210 Intraoral—complete series (including bite-wings) 00220 Intraoral periapical—single, first film 00230 Intraoral periapical—each additional film 00272 Bite-wing—two films 00274 Bite-wing—four films 00330 Panoramic—maxilla and mandible, film 00470 Diagnostic casts 01000-01999 Preventive 01100 Dental prophylaxis OHIO Adults 01120 Children 01200 Fluoride treatments 01201 Topical application of fluoride (includ ing prophylaxis]—children 01500 Space management therapy 01510 Fixed—unilateral type 02000-02999 Restorative 02100 Amalgam restorations (including polish ing) 02110 Amalgam—one surface, deciduous 02120 Amalgam—two surfaces, deciduous 02130 Amalgam—three surfaces, deciduous 02140 Amalgam—one surface, permanent 02150 Amalgam—two surfaces, permanent 02160 Amalgam—three surfaces, permanent 02161 Amalgam—four or more surfaces, per manent 02200 Silicate restorations 02210 Silicate cement per restoration 02300 Acrylic or plastic or composite restora tions 02310 Acrylic or plastic or composite resin 02335 Acrylic or plastic or composite resin (involving incisal angle) 02500 Gold inlay restorations 02520 Inlay—gold, two surfaces 02530 Inlay—gold, three surfaces 02540 Onlay—per tooth (in addition to forego ing) 02700-02899 Crowns—single restoration only 02720 Plastic with gold 02740 Porcelain 02750 Porcelain with gold 02790 Gold {full cast) 02810 Gold (3/4 cast) 02830 Prefabricated stainless steel—primary 02891 Cast post and core in addition to crown 02892 Prefabricated post and core in addition to crown 02900 Other restorative services 02920 Recement crowns
02940 Fillings (sedative) 02950 Crown buildup, pin retained 03000-03999 Endodontics 03100 Pulp capping 03110 Pulp cap—direct (excluding final resto ration) 03200 Pulpotomy (excluding final restoration) 03220 Vital pulpotomy 03300 Root canal therapy (includes treatment plan, clinical procedures, and follow-up care) 03310 Anterior (excludes final restoration) 03320 Bicuspid (excludes final restoration) 03330 Molar (excludes final restoration) 03400 Periapical services 03410 Apicoectomy—performed as separate surgical procedure (per root) 04000-04999 Periodontics 04210 Gingivectomy or gingivoplasty—per quadrant 04220 Gingival curettage—per quadrant 04260 Osseous surgery (including flap entry and closure)—per quadrant 04300 Adjunctive periodontal services (in con junction with total periodontal treatment) 04330 Occlusal adjustment (limited) 04331 Occlusal adjustment (complete) 04340 Periodontal scaling and root planing (entire mouth) 04341 Periodontal scaling and root planing— per quadrant 05000-05999 Prosthodontics, removable— including routine postdelivery care 05110 Complete upper 05120 Complete lower 05130 Immediate upper 05140 Immediate lower 05200 Partial dentures—including routine postdelivery care 05211 Upper, excluding clasps, acrylic base 05212 Lower, excluding clasps, acrylic base 05213 Upper—cast chrome base, with acrylic saddles, excluding clasps 05214 Lower—cast chrome base, with acrylic saddles, excluding clasps 05300 Additional units for partial dentures 05310 Each clasp with rest 05320 Each tooth 05600 Repairs to dentures 05610 Repair broken complete or partial denture— no teeth damaged 0562Q Repair broken complete or partial denture—replace one broken tooth 05630 Replace additional teeth—each tooth 05640 Replace broken tooth on denture—no other repairs 05650 Adding tooth to partial denture to re place extracted tooth—each tooth (not in volving clasp or abutment tooth)
80 ■ CODES FOR DENTAL PROCEDURES I JADA, Vol. 98, January 1979
05660 Adding tooth to partial denture to re place extracted tooth—each tooth (involving clasp or abutment tooth) Denture relining 05730 Relining upper or lower complete den ture (office reline) 05750 Relining upper or lower complete den ture (laboratory) 06000-06999 Prosthodontics, fixed 06200 Bridge pontics 06210 Cast gold 06240 Porcelain fused to gold 06250 Plastic processed to gold 06700 Crowns 06720 Plastic processed to gold 06750 Porcelain fused to gold 06780 Gold (3/4 cast) 06790 Gold (full cast) 06900 Other prosthetic services 06930 Recement bridge 07000-07999 Oral surgery 07100 Extractions—includes local anesthesia and routine postoperative care 07110 Single tooth 07120 Each additional tooth 07200 Surgical extractions—includes local anesthesia and routine postoperative care 07210 Surgical removal of erupted tooth, re quires elevation of mucoperiosteal flap and removal of bone and/or section of tooth 07220 Impaction that requires incision of overlying soft tissue and the removal of the tooth 07230 Impaction that requires incision of over lying soft tissue, elevation of a flap, and either removal of bone and tooth or section ing and removal of the tooth 0 7240 Impaction that requires incision of overlying soft tissue, elevation of a flap, removal of bone, and sectioning of the tooth for re moval 07250 Root recovery (surgical removal of re sidual root) 07300 Alveoloplasty (surgical preparation of ridge for dentures) 07310 Per quadrant—in conjunction with ex tractions 09000-09999 Adjunctive general services 09110 Palliative (emergency) treatment of den tal pain, minor procedures 09200 Anesthesia 09220 General 09300 Professional consultation—diagnostic service provided by physician or dentist other than practitioner providing treatment 09310 Consultation—per session