Most common D8604 code reviews : Removal of fixed orthodontic appliances for reasons other than completion of treatment - not covered, Removal of implant; superficial (e.g., buried wire, pin, or rod) (Separate procedure) or Resin-based composite - four or more surfaces or involving the incisal angle (anterior).
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.
Procedure in D8604 which the nearly exposed pulp is covered with a protective dressing to protect the pulp from dditional injury and to promote healing and repair via formation of secondary dentin This code is not to be used for bases and iners when all caries has been removed.
There is a succedaneous tooth #29 present on a radiograph, but it will be several years before it erupts Endodontic treatment is requested on tooth T in order to maintain this tooth and its space in the arch Treatment is performed on the tooth, and the canals are filled with a resorbable material. A temporary restoration is placed, and the patient is referred back to the referring dentist for a final restoration.
Prefabricated post and core in addition to crown is payable only on a completed endodontically treated tooth. If sufficient tooth structure remains, the fee for the post and core is Disallowed. **A prefabricated post and core for an anterior tooth is Benefited only when there is insufficient tooth structure to support an indirectly fabricated restoration. If sufficient tooth structure remains, the fee for the post and core is Disallowed.
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