Childrens Dental Covered Codes

re-cement or re-bond bilateral space maintainer - mandibular crown - resin/metal base connective tissue and double pedicle graft complete denture - mand D4249 local anesthesia D9939 prefabricated porcelain/ceramic crown – permanent tooth D4245 space maintainer - removable - unilateral D9930 D7510 D7511 D7997 sealant repair --per tooth rebase - partial denture - max D9950 D7530 D5110 D4263 trigeminal division block anesthesia D4260 apicoectomy - molar - first root D4261 Partial extraction for immediate implant placement veneer repair necessitated by restorative material failure implant supported crown - porcelain fused to titanium and titanium alloys D9941 3D facial surface scan – direct free soft tissue graft procedure (including recipient and donor surgical sites), each additional contiguous tooth, implant, or edentulous tooth position in same graft tissue D9943 bone graft for repair of peri-implant defect – not including flap entry and closure or, when indicated, placement of a barrier membrane or biologic materials to aid in osseous regeneration bitewing - four films D9945 D9944 cytology sample collection D9946 removal of reaction producing foreign bodies D7971 excision of periocoronal gingiva D7972 D9910 pontic crown - metal noble D9911 space maintainer - fixed - bilateral, mandibular frenuloplasty D4240 D4241 crown - 3/4 metal base immediate maxillary partial denture - flexible base (including any clasps, rests and teeth) overdenture - complete mandibular apexification/recalcification - interim replace missing or broken teeth - partial denture - per tooth implant supported retainer for metal FPD – titanium and titanium alloys cast post & core composite - 2 surface anterior D3357 splint - intra-coronal, natural teeth or prosthetic crowns D7957 D6624 D3355 D3356 pontic crown - indirect resin based composite D3353 extraoral - 1st film D3351 crown - porcelain fused to titanium and titanium alloys D3352 composite - 4+ surface posterior crown - porcelain/metal high noble precision attachment - by report coping interim complete denture - max D7956 3D facial surface scan – indirect retainer - porcelain/ceramic for resin bonded onlay - porcelain/ceramic 2 surface inlay - porcelain/ceramic - 3+ surface D7970 pulpal debridement - primary and permanent D6634 D4211 D4210 D7961 comprehensive - adolescent tissue conditioning - mand D7962 immediate denture - mand D7963 replacement of semi/precision attachment removal of fixed ortho appliance for reasons other than completion of Tx D6603 D6602 D3333 D5512 D6601 D5511 D6600 D3331 excisional biopsy of minor salivary glands D3332 apicoectomy (each additional root) D5751 D5993 abutment supported retainer - porcelain fused to titanium and titanium alloys D5750 D5992 D3330 D6609 guided tissue regeneration, natural teeth – non-resorbable barrier - per site D6608 cone beam CT capture and interpretation with field of view of both jaws, with or without cranium implant supported crown - noble alloys D6607 D6606 D6605 D6604 removable appliance therapy occlusal adjustment - limited regional block anesthesia D3346 D6614 D3347 D6613 reline - partial denture - mand - indirect D5765 D6612 D6611 D6610 recement crown D5520 D5761 D5760 gingival flap w/ root planing- 1 to 3 teeth per quad D3348 precision attachment D6615 intraoral tomosynthesis - periapical radiographic image implant supported crown - full metal high noble D5731 D5730 fluoride varnish D3310 D7910 occlusal adjustment - complete retainer - met for resin bonded alveoloplasty w/o extractions - 1 - 3 teeth/spaces per quad desensitizing resin - per tooth occlusal orthotic device adjustment interim partial denture - (including retentive/clasping materials, rests, and teeth), maxillary D3320 D5741 D5740 oral/facial photographic image pontic crown - titanium abutment supported crown - porcelain/metal noble crown - prefab stainless steel w/ window replace missing or broken teeth-complete denture - per tooth incomplete endodontic therapy space maintainer - fixed - unilateral crown - resin/metal noble debridement of a peri-implant defect and surface cleaning of exposed implant surfaces, including flap entry and closure D0270 removal of implant body not requiring bone removal nor flap elevation D1354 D1353 D5711 D5710 each additional prefab post D1110 D1352 inlay - metal base 3+ surface D1351 guided tissue regeneration, edentulous area – non-resorbable barrier, per site add tooth to existing partial denture - per tooth splint - extra-coronal, natural teeth or prosthetic crowns removable unilateral partial denture – one piece resin (including retentive/clasping materials, rests, and teeth) – per quadrant oroantral fistula closure crown - 3/4/metal noble D0277 D5721 D5720 D0272 D0273 pulpal regeneration - completion of treatment D0274 D1120 abutment supported crown - porcelain/metal high noble Scaling and debridement of a single implant in the presence of mucositis, including inflammation, bleeding on probing, and increased pocket depths; includes cleaning of the implant surfaces without flap entry and closure D5725 space maintainer - fixed - bilateral, maxillary implant/abutment supported removable denture -complete- mandibular amalgam - 1 surface autogenous connective tissue graft procedure D2663 D2662 re-cement or re-bond fixed retainer – maxillary pontic crown – porcelain/metal noble D1575 D2664 onlay - porcelain/ceramic 3+ surface D0240 pedicle soft tissue graft onlay - porcelain/ceramic - 3 surface free soft tissue graft procedure (including recipient and donor surgical sites), first tooth, implant, or edentulous tooth position in same graft tissue 3D intraoral surface scan – direct sealant - per tooth pulpal therapy - anterior primary bone replacement graft - 1st site in quad removal of torus mandibularis surgical revision - per tooth recement bridge occlusal guard - soft appliance, full arch D0250 tomographic survey D0251 abutment supported retainer - crown - full metal base retreatment - molar abutment supported retainer - crown - porcelain/metal base soft liner for complete or partial removable denture - indirect intraoral - comprehensive series of radiographic images D0220 D1552 implant supported retainer for FPD - porcelain fused to noble alloys D1551 D2643 D1553 D2642 D0460 re-evaluation D1556 D2644 D1558 D1557 occlusal guard adjustment intraoral - occlusal film removal of foreign body surgical reduction of tuberosity crown - 3/4 porcelain/ceramic impaction - partially bony D2652 D2651 inlay - porcelain/ceramic 3+ surface implant supported retainer - crown - porcelain/ceramic D0470 onlay - metal base 2 surface D2650 D0230 D2620 inlay repair necessitated by restorative material failure pontic crown - resin/metal noble alveoloplasty w/ extractions - 1 - 3 teeth/spaces per quad surgical removal of residual roots gingivectomy/gingivoplasty - 4+ teeth per quad stress breaker adjustment - partial denture - mand inlay - metal base 2 surface De-coronation or submergence of an erupted tooth sialography onlay - composite - 2 surface D2630 D0210 excision of hyperplastic tissue - per arch transseptal/supra crestal fiberotomy - by report therapeutic drug injection--two or more drugs replace all teeth - partial denture - max D9243 composite - 3 surface posterior pulpal regeneration - initial visit D1510 fixed appliance therapy D1516 fabrication of athletic mouthguard D1517 replacement of lost or broken retainer – mandibular D9239 abutment supported crown -full metal high noble D0425 endodontic therapy, premolar tooth (excluding final restoration) crown -full metal high noble surgical placement of mini implant D2610 D1520 oral evaluation for a patient under 3 years of age post removal D1527 D1526 D9248 guided tissue regeneration, natural teeth - resorbable barrier- per site guided tissue regeneration – non-resorbable barrier, per implant other temporomandibular joint radiographic images - by report D6191 D7282 diagnostic casts D7283 D7284 D7285 overdenture - complete maxillary D7286 D9222 D7287 D9223 D6197 D6195 D6194 temporomandibular joint arthrogram, including injection periodic oral evaluation D6192 D7280 space maintainer - removable - bilateral, maxillary each additional cast post pediatric partial denture, fixed D9215 D3910 intravenous moderate (conscious) sedation/analgesia - each subsequent15 minute increment removal nonodontogenic cyst/tumor - 1.25 cm surgical access of unerupted tooth surgical repositioning of teeth onlay repair necessitated by restorative material failure D9230 inlay - metallic - 3+ surface crown - 3/4 metal high noble D7290 D7291 onlay - metal noble 3+ surface repair broken complete denture base, mandibular crown - full metal noble D0415 fixed partial denture sectioning D0417 crown - prefab resin D3920 surgical repair of root resorption - premolar D3921 D7260 distal shoe space maintainer – fixed – unilateral deep sedation/general anesthesia - first 15 minutes replace all teeth - partial denture - mand endodontic therapy, anterior tooth (excluding final restoration) scaling in presence of generalized moderate or severe gingival inflammation – full mouth, after oral evaluation destruction of lesions) by physical/chemical - by report partial denture - resin base - mand D7259 implant maintenance procedure when a full arch fixed hybrid prosthesis is not removed. Includes cleansing of prosthesis and abutments implant supported crown - porcelain fused to noble alloys application of hydroxyapatite regeneration medicament - per tooth D6180 D7270 D7272 onlay - metallic - 4+surface D9210 apically positioned flap D9211 D9212 unscheduled dressing change osseous surgery - 1 to 3 teeth per quad crown - porcelain/ceramic D7240 D7241 resin retainer--for resin bonded fixed prosthesis D7485 removal of fixed bilateral space maintainer - mandibular amalgam - 3 surface composite - 1 surface anterior inhalation of nitrous oxide/ analgesia, anxiolysis root amputation - per root panoramic film D7250 D7251 D7252 detailed & extensive oral evaluation- problem focused, by report prefabricated porcelain/ceramic crown – primary tooth treatment of complications - post surgical - by report implant supported crown - porcelain/ceramic bridge repair - by report incision & drainage - intraoral - complicated intraoral tomosynthesis - bitewing radiographic image repair resin partial denture base, mandibular consultation D7460 retainer crown - porcelain fused to titanium and titanium alloys D7220 D5286 interim partial denture - (including retentive/clasping materials, rests, and teeth), mandibular extraction - surgical D5284 abutment supported crown - full metal noble D5283 D5282 reline - partial denture - mand - direct partial pulpotomy of apexogenesis prophylaxis - child D6123 vertical bitewings - 7 to 8 films maintenance and cleaning of a maxillofacial prosthesis implant/abutment supported fixed denture - partial---maxillary crown - prefab stainless steel - permanent D7471 D7230 D7472 D7473 vestibuloplasty w/ soft tissue grafts abutment supported crown - porcelain/metal base pontic crown - resin/metal high noble D7465 onlay - metallic - 3 surface recement implant/abutment supported fixed partial retreatment - anterior crown - resin D0804 implant supported retainer - porcelain fused to predominantly base alloys D7440 implant/abutment supported fixed denture - complete--mandibular pre - orthodontic treatment visit D6111 D6110 implant supported retainer for metal FPD – noble alloys D6107 D6106 D6105 placement of device to facilitate eruption of impacted tooth implant maintenance procedures when a full arch fixed hybrid prothesis is removed and reinserted D6104 D6103 D6102 D6101 implant supported retainer for metal FPD – predominantly base alloys D9610 D0801 D0802 D9612 D0803 bitewing - single film pin retention - per tooth D7450 D7210 D9630 D6122 D6121 D6120 D6117 D6116 D6115 D6114 limited ortho - adolescent D6113 periodontal maintenance D6112 ontoplasty - per tooth immediate maxillary partial denture - cast metal framework inlay - porcelain/ceramic - 2 surface implant removal - by report removal of fixed bilateral space maintainer - maxillary implant supported crown - porcelain/metal high noble occlusal guard - hard appliance, full arch D7410 D7413 rebase - complete denture - max semi-precision abutment - placement D6100 abutment supported crown - porcelain/ceramic repair - broken clasp partial denture recement implant/abutment supported crown guided tissue regeneration, edentulous area – resorbable barrier, per site amalgam - 4+ surface occlusal orthotic device - by report D7880 suture of small wounds - 5.0 cm D7881 D6792 D6791 recement cast or prefabricated post and core D6790 inlay - metal noble 3+ surface D6548 D5214 D6545 D5213 D5212 D5211 D6784 D6783 desensitizing medicament D6549 pontic crown - metal base surgical placement of implant body - endosteal implant onlay - porcelain/ceramic - 2 surface D4381 inlay - metallic - 1 surface D5228 D5227 crown - prefab stainless steel - primary D5226 D5225 D5224 D5223 non-intravenous conscious sedation/analgesia D5222 D5221 D6794 mobilization of erupted tooth implant/abutment supported removable denture - partial---mandibular composite crown - anterior retainer crown ¾ - titanium and titanium alloys immediate mandibular partial denture - cast metal framework reline- complete denture - max - indirect distal/proximal wedge placement of a custom removable clear plastic temporary aesthetic appliance crown - full metal high noble D4346 overdenture - partial maxillary D4341 crown - titanium surgical procedure for isolation of tooth D4342 core buildup including any pins when required periodic orthodontic treatment visit D8703 D8704 inlay - titanium composite - 4+ surface anterior full mouth debridement to enable a comprehensive periodontal evaluation and diagnosis on a subsequent visit D6782 orthodontic retention D6781 D6780 crown - porcelain/metal noble intraoral tomosynthesis - comprehensive series of radiographic images crown - full metal base crown lengthening - hard tissue bitewing - three films D4355 onlay - metal high noble 2 surface abutment supported crown - full metal base implant/abutment supported removable denture - complete-maxillary tissue conditioning - max inlay - metal noble 2 surface pulpal therapy - posterior primary abutment supported retainer - crown - porcelain/ceramic immediate mandibular partial denture - resin base D2391 D5660 D2390 D3240 D2393 D2150 D2392 prefabricated abutment D4323 D6985 D5411 D4322 D5410 D3230 D3472 D6740 D3473 D5650 rebase - partial denture - mand D2160 D5671 D5670 D2161 complete denture - max reline - partial denture - max - indirect inlay - metal high noble 3+ surface occlusion analysis - mounted case local anesthesia w/o operative or surgical procedure inlay - composite - 3+ surface Placement of interim direct restorations space maintainer - removable - bilateral, mandibular D5422 D6753 D2394 D5421 D6752 D6751 D6750 bone graft at time of implant placement D3460 removal of lateral exostosis - max or mand retreatment of previous root canal therapy - premolar replacement of lost or broken retainer – maxillary impaction - soft tissue endodontic endosseous implant D5876 D5875 D6722 D6721 vestibuloplasty - secondary epithelization D6720 D5630 D3450 amalgam - 2 surface add clasp - partial denture recement inlay apexification/recalcification - final implant supported retainer - crown - full metal high noble abutment supported retainer crown for FPD - titanium D3470 D6980 D3471 D2140 excision benign lesion - 1.25 cm extraoral posterior dental radiographic image D3221 D3222 D5640 D3220 osseous surgery - 4+ teeth per quad apicoectomy - premolar (first root) incision & drainage - intraoral coronectomy - intentional partial tooth removal, impacted teeth only tooth reimplantation D0170 D0171 removal of torus palatinus D5612 crown - indirect resin based composite D5611 re-cement or re-bond fixed retainer – mandibular D3430 D5851 D6940 onlay - composite - 4+ surface D5850 adjustment - complete denture - mand treatment of root canal obstruction implant/abutment supported fixed denture - partial--mandibular re-evaluation--post op D5866 D5865 D5622 D5864 retrograde filling - per root D5621 D5863 D6710 D5862 D6950 reline- complete denture - max - direct biopsy of oral tissue - soft abutment supported retainer - crown - porcelain/metal high noble reline - complete denture - mand - indirect D5867 crown - 3/4 resin - does not include facial veneers immediate maxillary partial denture - resin base collection and preparation of saliva sample for lab implant supported crown - titanium and titanium alloys adjustment - partial denture - max D0145 re-cement or re-bond bilateral space maintainer - maxillary D3410 D6920 D0140 surgical placement - eposteal implant D0160 abutment supported retainer - crown - full metal noble D2332 overdenture - partial mandibular D2335 D3421 implant/abutment supported removable denture - partial--maxillary D6930 D0150 partial denture - resin base - max D2331 D2330 D3425 D3426 cephalometric film D2542 reline - partial denture - max - direct D5811 D2783 D5810 D2544 D2543 D2780 D2782 D0120 D2781 endodontic therapy, molar tooth (excluding final restoration) D0367 removal of fixed unilateral space maintainer - per quadrant D0374 D2794 D5821 D5820 D2791 D2790 D0372 D0373 D2792 intravenous moderate (conscious) sedation/analgesia - first 15 minutes intentional reimplantation w/ splinting abutment supported crown - porcelain fused to titanium and titanium alloys D2520 pontic crown - porcelain/ceramic repair of implant/abutment supported prosthesis D0340 surgical placement - transosteal implant adjustment - complete denture - max implant supported crown - porcelain fused to predominantly base alloys apicoectomy - anterior intraoral - periapical 1st film D8080 intraoral - periapical each additional interim caries arresting medicament application - per tooth D2530 bone replacement graft - additional site in quad D0350 D1208 buccal / labial frenectomy (frenulectomy) inlay - composite - 1 surface D1206 pontic crown - resin/metal base immediate mandibular partial denture - flexible base (including any clasps, rests and teeth) reline - complete denture - mand - direct inlay - porcelain/ceramic - 1 surface pulp vitality tests rebase - complete denture - mand D2740 D2982 D0320 D2981 D4920 D0321 D0322 D2983 D2980 composite - 1 surface posterior impaction - completely bony - surgical complications abutment supported crown - titanium non-autogenous connective tissue graft procedure composite - 2 surface posterior connecting bar - implant supported or abutment supported limited oral evaluation D0330 D2751 D2750 limited ortho - transitional D2753 D2510 D2752 D2991 preventive resin restoration composite - 3 surface anterior add metal substructure to acrylic full denture (per arch) abutment supported retainer - crown - porcelain/metal noble onlay - metal base 3+ surface Nerve dissection D6092 D6091 D8030 D6090 D9120 partial denture - metal base - max excision malignant lesion - 1.25 cm D6099 D6098 D6097 D6094 D6093 removable unilateral partial denture – one piece flexible base (including retentive/clasping materials, rests, and teeth) – per quadrant D2720 lingual frenectomy (frenulectomy) modification of removable prosthesis D2722 D2721 appliance removal - not by dentist who placed appliance onlay - metal high noble 3+ surface connector bar D0310 crown - resin/metal high noble D2975 partial denture - flexible base - max D4910 interim complete denture - mand D6070 bitewing - two films D8010 palliative treatment of dental pain - per visit D6077 D6076 D6075 D6074 implant/abutment supported fixed denture - complete--maxillary D6073 D6072 D6071 removal of non-resorbable barrier D2940 removable unilateral partial denture - one piece cast metal (including retentive/clasping materials, rests, and teeth), maxillary D6069 D6068 other drugs/medications - by report D6081 D6080 D8020 repair resin partial denture base, maxillary D9110 D6088 D6087 D6086 D6084 D6083 D6082 D2951 D2950 inlay - composite - 2 surface D2957 D2953 hemisection D2710 D2952 D2955 D2712 D2954 D2928 D2929 caries susceptibility tests D6056 replacement of replaceable part of semi-precision /precision attach implant/abutment D6055 apexification/recalcification - initial D7140 bacteriologic studies D6050 crown - prefab esthetic coated stainless steel - primary occlusal guard - hard appliance, partial arch onlay - titanium D2920 inlay - metallic - 2 surface D6067 D6066 D6065 D6064 D6063 custom abutment D6062 D6061 D6060 D6059 D6058 D6057 D2934 biopsy of oral tissue - hard D2931 D2930 implant supported retainer – porcelain fused to titanium and titanium alloys D2933 D2932 alveoloplasty w/o extractions per quad D8210 D8695 inlay - porcelain/ceramic 2 surface guided tissue regeneration – resorbable barrier, per implant soft tissue allograft pontic crown - porcelain/metal base scaling and root planing - 4+ teeth per quad re-cement or re-bond unilateral space maintainer - per quadrant repair - cast partial framework, maxillary D8220 D9310 partial denture - flexible base - mand repair broken complete denture base, maxillary pontic - porcelain fused to titanium and titanium alloys prefab post & core D6040 3D dental surface scan – indirect alveoloplasty w/ extractions per quad D8698 D2915 D8699 rebase hybrid prosthesis D2910 onlay - metal noble 2 surface D8670 D7340 internal root repair - perforation crown - porcelain/metal base D6010 D6252 D6251 D6250 surgical repair of root resorption - anterior pulpal regeneration - interim medication replacement D6245 removable unilateral partial denture - one piece cast metal (including retentive/clasping materials, rests, and teeth), mandibular immediate denture - max surgical repair of root resorption - molar subepithelial tissue graft D8680 D7350 implant supported crown - predominantly base alloys onlay - composite - 3 surface adjust maxillofacial prosthetic appliance, by report replacement of restorative material used to close an access opening of a screw-retained implant supported prosthesis, per implant D6013 scaling and root planing - 1 to 3 teeth per quad tooth transplantation w/ splinting D7320 D7321 Topical Fluoride D5140 removal odontogenic cyst/tumor - 1.25 cm debridement and osseous contouring of a peri-implant defect; includes surface cleaning of exposed implant surfaces and flap entry and closure D4286 prophylaxis - adult D7311 pontic crown - metal high noble surgical reduction of fibrous tuberosity extraction - erupted tooth or exposed root D8660 D6243 D6242 therapeutic drug injection - by report D6241 D6240 implant supported retainer - crown - porcelain/metal high noble partial denture - metal base - mand comprehensive oral evaluation impaction - completely bony deep sedation/general anesthesia - each subsequent 15 minute increment chemotherapeutic agents - per tooth by report repair - cast partial framework, mandibular pulpotomy abutment supported retainer - crown -full metal high noble onlay - porcelain/ceramic - 4+ surface onlay - metallic - 2 surface D7540 crown repair - by report D4273 D6210 D4274 D5120 pontic crown – porcelain/metal high noble D4270 D4268 D6205 D4266 D4267 D4264 D4265 D9952 D9951 gingivectomy/gingivoplasty - 1 to 3 teeth per quad D7310 D9971 gingival flap w/ root planing - 4+ teeth per quad D4285 D5130 D4283 excision malignant tumor - 1.25 cm limited ortho - primary D4277 D6214 D4278 D4275 D6212 D4276 D6211 biologic materials - regeneration inlay - metal high noble 2 surface