Most common D4069 code reviews : Implant/abutment supported interim fixed denture for edentulous arch - maxillary - not covered, Posterior-anterior or lateral skull and facial bone survey radiographic image 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 D4069 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.
Dental case management - patient education to improve oral health literacy. (Not covered service as opposed to when performed as follows: Disallowed when performed on same date of service as nutrition, tobacco counseling and/or oral hygiene instructions.)
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.