Complete-Dental-Codes-1.png

A Complete set of Dental Codes Part – 1

Medical codes are several in the healthcare billing industry. Dental codes are one of a kind that acts differently from medical coding. In the year 2021, medical coding changes took place as usual. To better understand the annual changes and adoptions, one must give credit to those working on our behalf to represent dentistry in the clinical environment. Not all can exhibit the same performance for dental coding. As it’s quite unique and different from medical coding, it requires keen observance and experience to know which dental codes can be used for certain procedures. Here, in this article, we provide the complete set of dental codes that applies to the Medicare Advantage Policy Guideline.

Dental codes Part-1:

  1. D0210 Intraoral-complete series of radiographic images [A radiographic survey of the whole mouth, usually consisting of 14-22 periapical and posterior bite-wing images intended to display the crowns and roots of all teeth, periapical areas, and alveolar bone].
  2. D0220 Intraoral-periapical first radiographic image
  3. D0230 Intraoral-periapical each addition radiographic image
  4. D0310 Sialography
  5. D0320 Temporomandibular Joint Arthrogram, including injection
  6. D0321 Other temporomandibular joint radiographic images, by report
  7. D0322 Tomographic survey
  8. D0330 Panoramic radiographic image
  9. D0340 2D cephalometric radiographic image acquisition, measurement, and analysis
  10. D0350 2D Oral/facial images, photographic images obtained intraorally or extraorally [This includes photographic images, including those obtained by intraoral and extraoral cameras, excluding radiographic images. These photographic images should be part of the patient’s clinical record.]
  11. D0351 3D photographic image
  12. D0701 Panoramic radiographic image – image capture only
  13. D0702 2-D cephalometric radiographic image – image capture only
  14. D07032-D oral/facial photographic image obtained intra-orally or extra-orally – image capture only
  15. D07043-D photographic image – image capture only
  16. D0705 Extra-oral posterior dental radiographic image – image capture only
  17. D0706 Intraoral – occlusal radiographic image – image capture only
  18. D0707 Intraoral – periapical radiographic image – image capture only
  19. D0708 Intraoral – bite-wing radiographic image – image capture only
  20. D0709 Intraoral – complete series of radiographic images – image capture only
  21. D1352 Preventive resin restoration in a moderate to high caries risk patient-permanent tooth
  22. D4210 Gingivectomy or gingivoplasty-four or more contiguous teeth or tooth bounded spaces per quadrant
  23. D4211 Gingivectomy or Gingivoplasty-one to three contiguous teeth or tooth bounded spaces per quadrant [Involves the excision of the soft tissue wall of the periodontal pocket by either an external or an internal bevel. It is performed to eliminate supra body pockets after adequate initial preparation, to allow access for restorative dentistry in the presence of supra body pockets, or to restore normal architecture when gingival enlargements or asymmetrical or unaesthetic topography is evident with normal bony configuration]
  24. D4212 Gingivectomy or gingivoplasty to allow access for the restorative procedure, per tooth
  25. D5913 Nasal prosthesis [Synonymous terminology: artificial nose; a removable prosthesis attached to the skin, which artificially restores part of the entire nose. Fabrication of a nasal prosthesis requires the creation of an original mold. Additional prostheses usually can be made from the same mold, and assuming no further tissue changes occur, the same mold can be utilized for extended periods of time. When a new prosthesis is made from the existing mold, this procedure is termed a nasal prosthesis replacement].
  26. D5914 Auricular prosthesis [Synonymous terminology: artificial ear, ear prosthesis; a removable prosthesis, which artificially restores part of the entire natural ear. Usually, a replacement prosthesis can be made from the original mold if tissue bed changes have not occurred. Creation of an auricular prosthesis requires fabrication of a mold, from which additional prostheses usually can be made, as needed later (auricular prosthesis, replacement).]
  27. D5915 Orbital prosthesis [A prosthesis, which artificially restores the eye, eyelids, and adjacent hard and soft tissue, lost as a result of trauma or surgery. Fabrication of an orbital prosthesis requires the creation of an original mold. Additional prostheses usually can be made from the same mold, and assuming no further tissue changes occur, the same mold can be utilized for extended periods of time. When a new prosthesis is made from the existing mold, this procedure is termed an orbital prosthesis replacement].
  28. D5916 Ocular prosthesis [Synonymous terminology: artificial eye, glass eye; a prosthesis, which artificially replaces an eye missing as a result of trauma, surgery, or congenital absence. The prosthesis does not replace missing eyelids or adjacent skin, mucosa, or muscle; the Ocular prosthesis requires semiannual or annual cleaning and polishing. Also, occasional revisions to re-adapt the prosthesis to the tissue bed may be necessary. Glass eyes are rarely made and cannot be re-adapted.]
  29. D5919 Facial prosthesis [Synonymous terminology: prosthetic dressing; a removable prosthesis, which artificially replaces a portion of the face, lost due to surgery, trauma, or congenital absence. Flexion of natural tissues may preclude the adaption and movement of the prosthesis to match the adjacent skin. Salivary leakage, when communicating with the oral cavity, adversely affects retention.]
  30. D5922  Nasal septal prosthesis [Synonymous terminology: Septal plug, septal button; Removable prosthesis to occlude (obdurate) a hole within the nasal septal wall. Adverse chemical degradation in this moist environment may require frequent replacement. Silicone prostheses are occasionally subject to fungal invasion.]
  31. D5923 Ocular prosthesis, interim [Synonymous terminology: Eye shell, shell, ocular conformer, conformer. A temporary replacement generally made of clear acrylic resin for an eye loss due to surgery or trauma. No attempt is made to re-establish esthetics. Fabrication of an interim ocular prosthesis generally implies subsequent fabrication of an aesthetic ocular prosthesis.]
  32. D5924 Cranial prosthesis [Synonymous terminology: Skull plate, cranioplasty prosthesis, cranial implant. A biocompatible, permanently implanted replacement of a portion of the skull bones; an artificial replacement for a portion of the skull bone.]
  33. D5925: Facial augmentation implant prosthesis [Synonymous terminology: facial implant. An implantable biocompatible material generally in layed upon an existing bony area beneath the skin tissue to fill in or collectively raise portions of the overlaying facial skin tissues to create acceptable contours.]
  34. D5926 Nasal prosthesis, replacement [Synonymous terminology: replacement nose. An artificial nose produced from a previously made mold. Replacement prosthesis does not require fabrication of a new mold. Generally, several prostheses can be made from the same mold assuming no changes occur in the tissue bed due to surgery or age-related topographical variations.]
  35. D5927 Auricular prosthesis, replacement [Synonymous terminology: replacement ear. An artificial ear produced from a previously made mold. Replacement prosthesis does not require fabrication of a new mold. Generally, several prostheses can be made from the same mold assuming no changes occur in the tissue bed due to surgery or age-related topographical variations.]
  36. D5928 Orbital prosthesis, replacement [A replacement for a previously made orbital prosthesis. Replacement prosthesis does not require fabrication of a new mold. Generally, several prostheses can be made from the same mold assuming no changes occur in the tissue bed due to surgery or age-related topographical variations.]
  37. D5929 Facial prosthesis, replacement [A replacement facial prosthesis made from the original mold. Replacement prosthesis does not require fabrication of a new mold. Generally, several prostheses can be made from the same mold assuming no changes occur in the tissue bed due to surgery or age-related topographical variations.]
  38. D5931 Obturator prosthesis, surgical [Synonymous terminology: Obturator, surgical stay plate, immediate temporary obturator. A temporary prosthesis inserted during or immediately following the surgical or traumatic loss of a portion or all of one or both maxillary bones and contiguous alveolar structures (e.g., gingival tissue, teeth). Frequent revisions of surgical obturators are necessary during the ensuing healing phase (approximately six months). Some dentists prefer to replace many or all teeth removed by the surgical procedure in the surgical obturator while others do not replace any teeth. Further surgical revisions may require fabrication of another surgical obturator (e.g., an initially planned small defect may be revised and greatly enlarged after the final pathology report indicates margins are not free of tumor).
  39. D5932 Obturator prosthesis, definitive [Synonymous terminology: obturator. A prosthesis, which artificially replaces part or all of the maxilla and associated teeth, lost due to surgery, trauma, or congenital defects. A definitive obturator is made when it is deemed that further tissue changes or recurrence of tumor are unlikely and a more permanent prosthetic rehabilitation can be achieved; it is intended for long-term use].
  40. D5933 Obturator prosthesis, modification [Synonymous terminology: adjustment, denture adjustment, temporary or office reline. Revision or alteration of an existing obturator (surgical, interim, or definitive); possible modifications include relief of the denture base due to tissue compression, augmentation of the seal or peripheral areas to effect adequate sealing or separation between the nasal and oral cavities].
  41. D5934 Mandibular resection prosthesis with guide flange [Synonymous terminology: resection device, resection appliance. A prosthesis that guides the remaining portion of the mandible, left after partial resection, into a more normal relationship with the maxilla. This allows for some tooth-to-tooth or an improved tooth contact. It may also artificially replace missing teeth and thereby increase masticatory efficiency].
  42. D5935 Mandibular resection prosthesis without guide flange [A prosthesis which helps guide the partially resected mandible to more normal relationship with the maxilla allowing for increased tooth contract. It does not have a flange or ramp, however, to assist in directional closure. It may replace missing teeth and thereby increase masticatory efficiency. Dental professionals who treat mandibulectomy patients may refer to replace some, all or none of the teeth in the defect area. Frequently, the defect’s margins preclude even partial replacement. Use of a guide (a mandibular resection prosthesis with a guide flange) may not be possible due to anatomical limitation or poor patient tolerance. Ramps, extended occlusal arrangements, and irregular occlusal positioning relative to the denture foundation frequently preclude stability of the prostheses, and thus some prostheses are poorly tolerated under such adverse circumstances].
  43. D5936 Obturator prosthesis, interim [Synonymous terminology: immediate post-operative obturator. A prosthesis which is made following completion of the initial healing after surgical resection of a portion or all of one or both the maxillae; frequently many or all teeth in the defect area are replaced by this prosthesis. This prosthesis replaces the surgical obturator, which is usually inserted at, or immediately following the resection. Generally, an interim obturator is made to facilitate closure of the resultant defect after initial healing has been completed. Unlike the surgical obturator, which usually is made prior to surgery and frequently revised in the operating room during surgery, the interim obturator is made when the defect margins are clearly defined and further surgical revisions are not planned. It is a provisional prosthesis, which may replace some or all lost teeth, and other lost bone and soft tissue structures. Also, it frequently must be revised (termed an obturator prosthesis modification) during subsequent dental procedures (e.g., restorations, gingival surgery) as well as to compensate for further tissue shrinkage before a definitive obturator prosthesis is made].
  44. D5937 Trismus appliance (not for TMD treatment) [Synonymous terminology: an occlusal device for mandibular trismus, dynamic bite opener. A prosthesis, which assists the patient in increasing their oral aperture width in order to eat as well as maintain oral hygiene. Several versions and designs are possible, all intending to ease the severe lack of oral opening experienced by many patients immediately following extensive intraoral surgical procedure].
  45. D5952 Speech aid prosthesis, pediatric [Synonymous terminology: nasopharyngeal obturator, speech appliance, obturator, cleft palate appliance, prosthetic speech aid, speech bulb. A temporary or interim prosthesis used to close a defect in the hard and/or soft palate. It may replace tissue lost due to developmental or surgical alterations. It is necessary for the production of intelligible speech. Normal lateral growth of the palatal bones necessitates occasional replacement of this prosthesis. Intermittent revisions of the obturator section can assist in the maintenance of the palatopharyngeal closure (termed a speech aid prosthesis modification). Frequently, such prostheses are not fabricated before the deciduous dentition has fully erupted since clasp retention is often essential]
  46. D5953 Speech aid prosthesis, adult [Synonymous terminology: prosthetic speech appliance, speech aid, speech bulb. A definitive prosthesis, which can improve speech in adult cleft palate patients either by obturating (sealing off) a palatal cleft or fistula or occasionally by assisting an incompetent soft palate. Both mechanisms are necessary to achieve velopharyngeal competency. Generally, this prosthesis is fabricated when no further growth is anticipated and the objective is to achieve long-term use. Hence, more precise materials and techniques are utilized. Occasionally such procedures are accomplished in conjunction with precision attachments in crown work undertaken on some or all maxillary teeth to achieve improved aesthetics].
  47. D5954 Palatal augmentation prosthesis [Synonymous terminology: superimposed prosthesis, maxillary glossectomy prosthesis, maxillary speech prosthesis, palatal drop prosthesis. A removable prosthesis that alters the hard and/or soft tissue palate’s topographical form adjacent to the tongue].
  48. D5955 Palatal lift prosthesis, definitive [A prosthesis that elevates the soft palate superiorly and aids in the restoration of soft palate functions which may be lost due to an acquired, congenital or developmental defect. A definitive palatal lift is usually made for patients whose experience with an interim palatal lift has been successful, especially if surgical alterations are deemed unwarranted].
  49. D5958 Palatal lift prosthesis, interim [Synonymous terminology: diagnostic palatal lift; A prosthesis which elevates and assists in restoring soft palate function which may be lost due to clefting, surgery, trauma, or unknown paralysis. It is intended for interim use to determine its usefulness in achieving palatopharyngeal competency or enhance swallowing reflexes. This prosthesis is intended for interim use as a diagnostic aid to assessing the level of possible improvement in speech intelligibility. Some clinicians believe the use of a palatal lift on an interim basis may stimulate an otherwise flaccid soft palate to increase functional activity, subsequently lessening its need].
  50. D5959 Palatal lift prosthesis, modification [Synonymous terminology: revision of lift, adjustment. Alterations in the adaptation, contour, form, or function of an existing palatal lift necessitated due to tissue impingement, lack of function, poor clasp adaptation, or the like].
  51. D5960 Speech aid prosthesis, modification [Synonymous terminology: adjustment, repair, revision. Any revision of a pediatric or adult speech aid not necessitating its replacement. Frequently, revisions of the obturating sections of any speech aid are required to facilitate enhanced speech intelligibility. Such revisions or repairs do not require a complete remaking of the prosthesis, thus extending its longevity].
  52. D5982 Surgical stent [Synonymous terminology: periodontal stent, skin graft stent, a columellar stent. Stents are utilized to apply pressure to soft tissue to facilitate healing and prevent cicatrization of collapse. A surgical stent may be required in surgical and post-surgical revisions to achieve a close approximation of tissues. Usually, such materials as temporary or interim soft denture liners, gutta-percha, or dental modeling impression compound may be used].
  53. D5988 Surgical splint [Synonymous terminology: Gunning splint, modified Gunning splint, labiolingual splint, fenestrated splint, Kingsley splint, cast metal splint; Splints are designed to utilize existing teeth and/or alveolar processes as points of anchorage to assist in stabilization and immobilization of broken bones during healing. They are used to re-establish, as much as possible, normal occlusal relationships during the process of immobilization. Frequently, existing prostheses (e.g., a patient’s complete dentures) can be modified to serve as surgical splints. Frequently, surgical splints have arch bars added to facilitate intermaxillary fixation. Rubber elastics may be used to assist in this process. Circummandubular eyelet hooks can be utilized for enhanced stabilization with wiring to adjacent bone].
  54. D5992 Adjust maxillofacial prosthetic appliance, by report
  55. D5993 Maintenance and cleaning of a maxillofacial prosthesis (extra or intraoral) other than required adjustments, by report
  56. D5994 Periodontal medicament carrier with peripheral seal-laboratory processed
  57. D5995 Periodontal medicament carrier with peripheral seal – laboratory-processed – maxillary
  58. D5996 Periodontal medicament carrier with peripheral seal – laboratory-processed – mandibular
  59. D5999 Unspecified maxillofacial prosthesis, by report
  60. D6010 Surgical placement of implant body: endosteal implant [Includes second stage surgery and placement of healing cap]
  61. D6011 Surgical access to an implant body (Second stage implant surgery)
  62. D6040 Surgical placement: eposteal implant [An eposteal (subperiosteal) framework of a bio-compatible material designed and fabricated to fit on the surface of the bone of the mandible or maxilla with per mucosal extensions which provide support and attachment of a peosthesis. This may be a complete arch or unilateral appliance. Eposteal implants rest upon the bone and under the periosteum].
  63. D6050 Surgical placement: transosteal implant [A transosteal (transossesous) bio-compatible device with threaded posts penetrating both the superior and inferior cortical bone plates of the mandibular symphysis and exiting through the permucosa provider support and attachment for a dental prosthesis. Transosteal implants are placed completely through the bone and into the oral cavity from extraoral or intraoral].
  64. D6055 Dental implant-supported connecting bar [A device attached to transmucosal abutments to stabilize and anchor a removable overdenture prosthesis]
  65. D6080 Implant maintenance procedures, including removal of the prosthesis, cleansing of prosthesis and abutments, and reinsertion of prosthesis [This procedure includes prophylaxis to provide active debriding of the implant and examination of all aspects of the implant system, including the occlusion and stability of the superstructure. The patient is also instructed in thorough daily cleansing of the implant].
  66. D6090 Repair implant support prosthesis, by report [This procedure involves the repair or replacement of any part of the implant-supported prosthesis].
  67. D6095 Repair implant abutment, by report. This procedure involves the repair or replacement of any part of the implant abutment.

 

All these codes serve dental providers to ensure proper metrics and correct reporting of procedures. Ensure you use accurate codes for that particular diagnosis or procedure. Click here to read the other parts.

 

For more queries and information on healthcare, please subscribe to our blog. Do write to us in the comment section and we shall consider them if relevant to the topic. Follow us on social media portals to know us better.

Comments are closed.