Most common D3495 code reviews : Pulpal Debridement, Primary or Permanent Tooth - Paid to the general dentist that will not be completing the endodontic treatment, Scaling in the presence of generalized moderate or severe gingival inflammation - full mouth, after oral valuation or Accession of tissue, gross examination, preparation and transmission of written report.
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.
Separation of one or more connections between abutments and/or pontics when some portion of a fixed rosthesis is to remain intact D3495 and serviceable following sectioning and extraction or other treatment Includes all recontouring and olishing of retained portions.
Scaling and debridement in the presence of inflammation or mucositis of a single implant, including cleaning of the implant surfaces, without flap entry and closure. (When submitted with prophy, considered inclusive of prophy; no separate benefit for 6081 or when submitted alone or in multiples, allow to pay as prophy, but subject to prophy limitation.)
Sealant repair - per tooth - This procedure is disallowed when performed by the same dentist/dental office based on the same time limitation that exists for replacement of a sealant. It is allowed at 50% of D3495 when performed by a different provider or if after the time limitation for the same dentist.