HCPC|DESCRIPTION
00110|Medicare-CHS/EPSDT EXAMINATION
00120|Periodic oral exam established patient
00140|Limited oral evaluation - problem focused
00145|Oral evaluation for a patient under three years of age and counseling with primary caregiver
00150|Comprehensive oral evaluation - new or established patient comprehensive
00160|Detailed and extensive oral evaluation - problem focused, by report
00170|Re-evaluation-limited, problem focused (established patient; not post-op
00171|Re-evaluation post operative office visit
00180|Comprehensive periodontal evaluation - new or established patient
00190|Screening of a patient
00191|Assessment of a patient
00210|Intraoral-complete series of radiographic images
00220|Intraoral-periapical first radiographic image
00230|Intraoral-periapical each additional radiographic image
00240|Intraoral-occlusal radiographic image
00250|Extra-oral - 2d projection radiographic image created using a stationary radiation source, and detector
00251|Extra-oral posterior dental radiographic image
00260|Extraoral-each additional film
00270|Bitewing-single radiographic image
00272|Bitewings-two radiographic images
00273|Bitewings-three radiographic images
00274|Bitewings-four radiographic images
00275|Bitewings-each additional film
00277|Vertical bitewings-7 to 8 radiographic images
00290|Posterior-anterior or lateral skull and facial bone survey radiographic image
00310|Saliography
00320|Temporomandibular joint arthrogram, including injection
00321|Other temporomandibular joint radiographic images by report
00322|Tomographic survey
00330|Panoramic radiographic image
00340|2d celphalometric radiographic image - acquisition, measurement and analysis
00350|2d oral/facial photographic image obtained intra-orally or extra- orally
00351|3d photograhic image
00360|Cone beam ct - craniofacial data capture
00362|Cone beam - two-dimensional image reconstruction using existing data, includes multiple images
00363|Cone beam - three-dimensional image reconstruction using existing data, includes multiple images
00364|Cone beam ct capture and interpretation with limited field of view- less than one whole jaw
00365|Cone beam ct capture and interpretation with field of view of one full dental arch-mandible
00366|Cone beam ct capture and interpretation with field of view of one full dental arch-maxilla, with or without cranium
00367|Cone beam ct capture and interpretation with field of view of both jaws with or without cranium
00368|Cone beam ct capture and interpretation for tmj series including two or more exposures
00369|Maxillofacial mri capture and interpretation
00370|Maxilofacial ultrasound capture and interpretation
00371|Sialoendoscopy capture and interpretation
00380|Cone beam ct image capture with limited field of view-less than one whole jaw
00381|Cone beam ct image capture with field of view of one full dental arch-mandible
00382|Cone beam ct inmage capture with foeld of view of one full dental arch-maxilla, with or without cranium
00383|Cone beam ct image capture with field of view of view of both jaws, with or wothout cramium
00384|Cone beam ct image capture for tmj series including two or more exposures
00385|Maxillofacial mri image capture
00386|Maxillofacial ultrasound image capture
00391|Interpretation of diagnostic image by a practitioner not associated with capture of the image, including report
00393|Treatment simulation using 3d image valume
00394|Digital subtraction of two or more images or image volumes of the same modality
00395|Fusion of two or more 3d image volumes of one or more modalities
00411|HbA1c in - office point of service testing
00412|blood glucose level test in-office using a glucose meter.
00415|Collection of microorganisms for culture and sensitivity
00416|Viral culture
00417|Collection & preparation of saliva sample for laboratory diagnostic test
00418|Analysis of saliva sample
00419|ASSESSMENT SALIVARY FLOW MEASUREMNT
00421|Genetic test for susceptibility to oral diseases
00422|Collection and preparation of genetic sample material for laboratory analysis and report
00423|Genetic test for susceptibility to disease - specimen analysis
00425|Caries susceptibility tests
00431|Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities
00460|Pulp vitality tests
00470|Diagnostic casts
00472|Accession of tissue, gross examination, preparation and transmission of
00473|Accession of tissue, gross and microscopic examination, preparation and
00474|Accession of tissue, gross and microscopic examination, including assess
00475|Decalcification procedure
00476|Special stains for microorganisms
00477|Special stains, not for microorganisms
00478|Immunohistochemical stains
00479|Tissue in-situ hybridization, including interpretation
00480|Accession of exfoliative cytologic smears, microscopic examination, preparation and transmission of written report
00481|Electron microscopy-diagnostic
00482|Direct immunofluorescence
00483|Indirect immunofluorescence
00484|Consultation on slides prepared elsewhere
00485|Consultation, including preparation of slides from biopsy material supplied by referring source
00486|Accession transepithelial cytologic sample, microscopic examination, preparation and trasnmission of written report
00502|Other oral pathology procedures, by report
00601|Caries risk assessment and documentation, with a finding of low risk
00602|Caries risk assessment and documentation, with a finding of moderate risk
00603|Caries risk assessment and documentation, with a finding of high risk
00604|Antigen testing for a public health related pathogen includes coronavirus
00605|Antibody testing for a public health related pathogen includes coronavirus
00701|Panoramic radiographic image - image capture only
00702|2-D cephalometric radiographic image - image capture only
00703|2-D oral/facial photographic image obtained intra-orally or extra-orally - image capture only
00704|3-D photographic image - image capture only
00705|Extra-oral posterior dental radiographic image - image capture only
00706|Intraoral - occlusal radiographic image - image capture only
00707|Intraoral - periapical radiographic image - image capture only
00708|Intraoral - bitewing radiographic image - image capture only
00709|Intraoral - complete series of radiographic images - image capture only
00999|Unspecified diagnostic procedure, by report
01110|Prophylaxis - adult
01120|Prophylaxis - child
0120|Periodic oral exam established patient
01201|Topical Application of Fluoride (Including Prophylaxis)- Child
01203|Topical application of fluoride (prophylaxis not included)child (under 21 years of age)
01204|Topical application of fluoride (prophylaxis not included)adult (21 years of age and older)
01205|topical application of flouride (including prophylasix) -adult
01206|Topical application of fluoride varnish
01208|Topical application of fluoride
01290|Medicare-PEDRO-PROPHY&FLUORIDE
01291|Medicare-PROPHY & FLORIDE AGE 10 TO 20
01310|Nutritional counseling for the control of dental disease
01320|Tobacco counseling for the control and prevention of oral disease
01321|Counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use
01330|Oral hygiene instruction
01351|Sealant - per tooth
01352|Preventative resin restoration in a moderat to high caries risk patient-permanent tooth
01353|Sealant repair- per tooth
01354|Intermin caries arresting medicament application
01355|Caries preventive medicament application - per tooth
0140|Limited oral evaluation - problem focused
0145|Oral evaluation for a patient under three years of age and counseling with primary caregiver
0150|Comprehensive oral evaluation - new or established patient comprehensive
01510|Space maintainer - fixed-unilateral
01515|Space maintainer - fixed-bilateral (2019 deletion)
01516|space maintainer fixed bilateral, maxillary
01517|space maintainer fixed bilateral, mandibular
01520|Space maintainer - removable- unilateral
01525|Space maintainer - removable- bilateral (2019 deletion)
01526|space maintainer removable bilateral, maxillary
01527|space maintainer removable bilateral, mandibular
01550|Re-cement or re-bond space maintainer
01551|RE-CEM/RE-BOND BIL SPACE MNTNR-MAX
01552|RE-CEM/RE-BOND BIL SPC MNTNR - MAND
01553|RE-CEM/RE-BOND UNI SPACE MNTNR-QUAD
01555|Removal of fixed spacer maintainer
01556|REMV FIX UNI SPACE MNTNR - PER QUAD
01557|REMOVAL FIXED BIL SPACE MNTNR - MAX
01558|REMOVAL FIX BIL SPACE MNTNR - MAND
0160|Detailed and extensive oral evaluation - problem focused, by report
0170|Re-evaluation-limited, problem focused (established patient; not post-op
0171|Re-evaluation post operative office visit
0180|Comprehensive periodontal evaluation - new or established patient
0190|Screening of a patient
0191|Assessment of a patient
01999|Unspecified preventive procedure, by report
0210|Intraoral-complete series of radiographic images
02140|Amalgam-one surface, primary or permanent amalgam-one surface, primary o
02150|Amalgam-two surfaces, primary or permanent amalgam-two surfaces, primary
02160|Amalgam-three surfaces, primary or permanent amalgam-three surfaces, pri
02161|Amalgam-four or more surfaces, primary or permanent amalgam- four or more
0220|Intraoral-periapical first radiographic image
02222|Onlay-resin-based composite-four or more surfaces
0230|Intraoral-periapical each additional radiographic image
02330|Resin-one surface, anterior
02331|Resin-two surfaces, anterior
02332|Resin-three surfaces, anterior
02335|Resin-four or more surfaces on involving incisal angle
02390|Resin-based composite crown, anterior
02391|Resin-based composite - one surface, posterior
02392|Resin-based composite - two surfaces, posterior
02393|Resin-based composite - three surfaces, posterior
02394|Resin-based composite - four or more surfaces, posterior
0240|Intraoral-occlusal radiographic image
02410|Gold foil - one surface
02420|Gold foil - two surfaces
02430|Gold foil - three surfaces
0250|Extra-oral - 2d projection radiographic image created using a stationary radiation source, and detector
0251|Extra-oral posterior dental radiographic image
02510|Inlay - metallic - one surface
02520|Inlay - metallic -two surfaces
02530|Inlay - metallic - three  surfaces
02542|Onlay-metallic-two surfaces
02543|Onlay - metallic - three surfaces
02544|Onlay - metallic - four or more surfaces
0260|Extraoral-each additional film
02610|Inlay - porcelain/ceramic - one surface
02620|Inlay - porcelain/ceramic-two surfaces
02630|Inlay - porcelain/ceramic-three surfaces
02642|Onlay - porcelain/ceramic - two surfaces
02643|Onlay - porcelain/ceramic - three surfaces
02644|Onlay - porcelain/ceramic - four or more surfaces
02650|Inlay - resin-based composite - one surface inlay - resin-based composit
02651|Inlay - resin-based composite - two surfaces inlay - resin-based composi
02652|Inlay - resin-based composite - three or more surfaces inlay - resin-bas
02662|Onlay - resin-based composite - two surfaces onlay - resin-based composi
02663|Onlay - resin-based composite - three surfaces onlay - resin- based compo
02664|Onlay - - resin-based composite - four or more surfaces onlay - - resin-
0270|Bitewing-single radiographic image
02710|Crown-resin-based composite (indirect)
02712|Crown - 3/4 resin-based composite (indirect)
0272|Bitewings-two radiographic images
02720|Crown-resin with high noble metal
02721|Crown-resin with predominantly base metal
02722|Crown-resin with noble metal
0273|Bitewings-three radiographic images
0274|Bitewings-four radiographic images
02740|Crown-porcelain/ceramic substrate
0275|Bitewings-each additional film
02750|Crown-porcelain fused to high noble metal
02751|Crown-procelain fused to predominantly base metal
02752|Crown-porcelain fused to noble metal
02753|CRWN - PORCLN FUSD TO TIT & TIT ALY
0277|Vertical bitewings-7 to 8 radiographic images
02780|Crown - 3/4 cast high noble metal
02781|Crown - 3/4 cast predominantly base metal
02782|Crown - 3/4 cast noble metal
02783|Crown - 3/4 porcelain/ceramic
02790|Crown - full cast high noble metal
02791|Crown - full cast predominantly base metal
02792|Crown - full cast noble metal
02794|Crown-titanium
02799|Provisional crown-further treatment or completion of diagnosis necessary prior to final impression
0290|Posterior-anterior or lateral skull and facial bone survey radiographic image
02910|Recement inlay, onlay or partial coverage restoration
02915|Recement cast or prefabricated post and core
02920|Recement crown
02921|Reattachment of tooth fragment, incisal edge or cusp
02928|Prefabricated porcelain/ceramic crown - permanent tooth
02929|Prefabricated porcelain/ceramic crown-primary tooth
02930|Prefabricated stainless steel crown - primary tooth
02931|Prefabricated stainless steel crown - permanent tooth
02932|Prefabricated resin crown
02933|Prefabricated stainless steel crown with resin window
02934|Prefabricated esthetic coated stainless steel crown - primary tooth
02940|Protective restoration post removal
02941|Interim therapeutic restoration- primary dentition
02949|Restorative foundation for an indirect restoration
02950|Core buildup, including any pins when required
02951|Pin retention - per tooth, in addition to restoration
02952|Post and core in addition to crown, indirectly fabricated
02953|Each additional indirectly fabricated post - same tooth
02954|Prefabricated post and core in addition to crown
02955|Post removal (not in conjuction with endodontic therapy)
02957|Each additional prefabricated post - same tooth
02960|Labial veneer (laminate)-chairside
02961|Labial veneer (resin laminate)- laboratory
02962|Labial veneer (porcelain laminate)- laboratory
02970|Temporary crown (fractured tooth)
02971|Additional procedures to construct new crown under existing partial denture
02975|Coping
02980|Crown repair necessitated by restorative material failure
02981|Inlay repair necessitaed by restorative material failure
02982|Onlay repair necessitated by restorative material failure
02983|Vaneer repair necessitated by restorative material failure
02990|Resin infiltration of incipient smooth surface lesions
02999|Unspecified restorative procedure, by report
0310|Saliography
03110|Pulp cap - direct (excluding final restoration)
03120|Pulp cap -indirect  (excluding final restoration)
0320|Temporomandibular joint arthrogram, including injection
0321|Other temporomandibular joint radiographic images by report
0322|Tomographic survey
03220|Therapeutic pulpotomy (excluding final restoration)  removal of pulp cor
03221|Pulpal debridement, primary and permanent teeth pulpal debridement, prim
03222|Partial pulpotomy for apexogenesis - permanent tooth with incompleted root development
03230|Pulpal therapy (resorbable filling)-anterior, primary tooth (excluding f
03240|Pulpal therapy (resorbable filling)-posterior, primary tooth (excluding
0330|Panoramic radiographic image
03310|Endodontic therapy, anterior tooth (excluding final restoration)
03320|Endodontic therapy, bicuspid tooth (excluding final restoration)
03330|Endodontic therapy, molar (excluding final restoration)
03331|Treatment of root canal obstruction; non-surgical access
03332|Incomplete endodontic therapy; inoperable, unrestorable or fractured tooth
03333|Internal root repair of perforation defects
03346|Retreatment-anterior, by report
03347|Retreatment-bicuspid, by report
03348|Retreatment-molar, by report
03351|Apexification/ recalcification- initial visit (apical closure/ calcific repair of perforations, root resorption, pulp space disinfection, etc.)
03352|Apexification/recalcification- interim medication replacement
03353|Apexification/recalcification-final visit (includes completed root canal
03355|Pulpal regeneration- initial visit
03356|Pulpal regeneration- interim medication replacement
03357|Pulpal regeneration- completion of treatment
0340|2d celphalometric radiographic image - acquisition, measurement and analysis
03410|Apicoectomy- anterior
03421|Apicoectomy- bicuspid (first root)
03425|Apicoectomy- molar (first root)
03426|Apicoectomy- each additional root
03427|Periradicular surgery without apicoectomy - Deleted 2021
03428|Bone graft in conjunction with periradicular surgery- per tooth, single site
03429|Bone graft in conjunction with periradicular surgery- each additional contiguous tooth in the same surgical site
03430|Retrograde filling - per root
03431|Biological material to aid in soft and osseous tissue regeneration in conjunction with periradicular surgery
03432|Guided tissue regeneration, resorbable barrier, per site, in conjuction with periradicular surgery
03450|Root amputation - per root
03460|Endodontic endosseous implant
03470|Intentional replantation (including necessary splinting)
03471|Surgical repair of root resorption - anterior
03472|Surgical repair of root resorption - premolar
03473|Surgical repair of root resorption - molar
0350|2d oral/facial photographic image obtained intra-orally or extra- orally
03501|Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior
03502|Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar
03503|Surgical exposure of root surface without apicoectomy or repair of root resorption - molar
0351|3d photograhic image
0360|Cone beam ct - craniofacial data capture
0362|Cone beam - two-dimensional image reconstruction using existing data, includes multiple images
0363|Cone beam - three-dimensional image reconstruction using existing data, includes multiple images
0364|Cone beam ct capture and interpretation with limited field of view- less than one whole jaw
0365|Cone beam ct capture and interpretation with field of view of one full dental arch-mandible
0366|Cone beam ct capture and interpretation with field of view of one full dental arch-maxilla, with or without cranium
0367|Cone beam ct capture and interpretation with field of view of both jaws with or without cranium
0368|Cone beam ct capture and interpretation for tmj series including two or more exposures
0369|Maxillofacial mri capture and interpretation
0370|Maxilofacial ultrasound capture and interpretation
0371|Sialoendoscopy capture and interpretation
0380|Cone beam ct image capture with limited field of view-less than one whole jaw
0381|Cone beam ct image capture with field of view of one full dental arch-mandible
0382|Cone beam ct inmage capture with foeld of view of one full dental arch-maxilla, with or without cranium
0383|Cone beam ct image capture with field of view of view of both jaws, with or wothout cramium
0384|Cone beam ct image capture for tmj series including two or more exposures
0385|Maxillofacial mri image capture
0386|Maxillofacial ultrasound image capture
0391|Interpretation of diagnostic image by a practitioner not associated with capture of the image, including report
03910|Surgical procedure for isolation of tooth with rubber dam
03920|Hemisection (including any root removal), not including root canal thera
0393|Treatment simulation using 3d image valume
0394|Digital subtraction of two or more images or image volumes of the same modality
0395|Fusion of two or more 3d image volumes of one or more modalities
03950|Canal preparation and fitting of preformed dowel or post
03999|Unspecified endodontic procedure, by report
0411|HbA1c in - office point of service testing
0412|blood glucose level test in-office using a glucose meter.
0415|Collection of microorganisms for culture and sensitivity
0416|Viral culture
0417|Collection & preparation of saliva sample for laboratory diagnostic test
0418|Analysis of saliva sample
0419|ASSESSMENT SALIVARY FLOW MEASUREMNT
0421|Genetic test for susceptibility to oral diseases
04210|Gingivectomy or gingivoplasty- four or more contiguous teeth or tooth bounded spaces per quadrant, performed to eliminate suprabony pockets
04211|Gingivectomy or gingivoplasty one to three contiguous teeth or tooth bounded spaces per quadrant
04212|Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth
0422|Collection and preparation of genetic sample material for laboratory analysis and report
0423|Genetic test for susceptibility to disease - specimen analysis
04230|Anatomical crown exposure - four or more contiguous teeth per quadrant
04231|Anatomical crown exposure - ont to three teeth per quadrant
04240|Gingival flap procedure including root planning - four or more continguous teeth or tooth bounded spaces per quadrant
04241|Gingival flap procedure including root planning - one to three continguous teeth or tooth bounded spaces per quadrant
04245|Apically positioned flap
04249|Crown lengthening-hard and soft tissue, by report
0425|Caries susceptibility tests
04260|Osseous surgery (including elevation of a full thickness flap and closure)- four or more contiguous teeth or tooth bounded space per quandrant
04261|Osseous surgery (including elevation of a  full thickness flap and closure)- one to three contiguous teeth or tooth bounded spaces per quandrant
04263|Bone replacement graft - first site in quadrant
04264|Bone replacement graft - each additional site in quadrant
04265|Biologic materials to aid in soft and osseous tissue regeneration
04266|Guided tissue regeneration- resorbable barrier, per site
04267|Guided tissue regeneration-non- resorbable barrier, per site (includes membrane removal)
04268|Surgical revision procedure, per tooth
04270|Pedicle soft tissue graft procedure
04271|Free soft tissue graft procedure (including donor site surgery)
04272|Apically repositioning flap procedure
04273|Autogenous connective tissue graft procedures (including donor and recipient surgical sites) first tooth, implant, or edentulous tooth position in graft
04274|Distal or proximal wedge procedure (when not performed in conjuction wit
04275|Non-autogenous connective tissue graft (including recipient site and donor material) first tooth, implant, or edentulous tooth position in graft
04276|Combined connective tissue and double pedicle graft, per tooth
04277|Free soft tissue graft procedure (including recipient and donor surgical sites) first tooth, implant, or edentulous tooth position in graft
04278|Free soft tissue graft procedure (including recipient and donor surgical sites) each additional tooth, implant, or edentulous tooth position in graft
04283|Autogenous connective tissue graft procedure (including donor and recipient surgical sites) - each additional contiguous tooth, implant or edentulous tooth position in same graft site
04285|Non-autogenous connective tissue graft procedure (including recipient surgical site and donor material) - each additional contiguous tooth, implant or edentulous tooth postiiion in same graft site
0431|Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities
04320|Provisional splinting - intracoronal
04321|Provisional splinting - extracoronal
04341|Periodontal scaling and root planing - four or more teeth per quadrant
04342|Periodontal scaling and root planing - one to three teeth, per quadrant
04355|Full mouth debridement to enable comprehensive evaluation and diagnosis
04381|Localized delivery of antimicrobial via a controlled release vehicle into diseased crevicular tissue per tooth
0460|Pulp vitality tests
0470|Diagnostic casts
0472|Accession of tissue, gross examination, preparation and transmission of
0473|Accession of tissue, gross and microscopic examination, preparation and
0474|Accession of tissue, gross and microscopic examination, including assess
0475|Decalcification procedure
0476|Special stains for microorganisms
0477|Special stains, not for microorganisms
0478|Immunohistochemical stains
0479|Tissue in-situ hybridization, including interpretation
0480|Accession of exfoliative cytologic smears, microscopic examination, preparation and transmission of written report
0481|Electron microscopy-diagnostic
0482|Direct immunofluorescence
0483|Indirect immunofluorescence
0484|Consultation on slides prepared elsewhere
0485|Consultation, including preparation of slides from biopsy material supplied by  referring source
0486|Accession transepithelial cytologic sample, microscopic examination, preparation and trasnmission of written report
04910|Periodontal maintenance periodontal maintenance
04920|Unscheduled dressing change (by someone other than treating dentist)
04921|Gingival irrigation - per quadrant
04999|Unspecified periodontal procedure, by report
0502|Other oral pathology procedures, by report
05110|Complete upper
05120|Complete lower
05130|Immediate upper
05140|Immediate lower
05211|maxillary partial denture G?? resin base (including any conventional clasps, rests and t
05212|mandibular partial denture - resin base (including any conventional clasps, rests and t
05213|Upper partial-cast metal base with resin saddles (including any conventi
05214|Lower partial-cast metal base with resin saddles (including any conventi
05221|Immediate maxillary partial denture- resin base (including any conventional clasps, rests, and teeth)
05222|Immediate mandibular partial denture- resin base (including any conventional clasps, rests, and teeth)
05223|Immediate maxillary partial denture- cast metal framework with resin denture bases (including any conventional clasps, rests, and teeth)
05224|Immediate mandibular partial denture- cast metal framework with resin denture bases (including any conventional clasps, rests, and teeth)
05225|Maxillary partial denture - flexible base (including any clasps, rests and
05226|Mandibular partial denture - flexible base (including any clasps, rests and
05227|Immediate maxillary partial denture - flexible base (including any clasps, rests and teeth) Covered once in a seven year period.
05228|Immediate mandibular partial denture - flexible base (including any clasps, rests and teeth)
05281|Removable unilateral partial denture-one piece cast metal (2019 Deletion)
05282|removable unilateral partial denture one-piece cast metal (including clasps and teeth), maxillary
05283|removable unilateral partial denture one-piece cast metal (including clasps and teeth), mandibular
05284|REMV UNI PRTL D 1 PC FLEX BASE QUAD
05286|REM UNI PRTL D - 1 PC RESIN - QUAD
05410|Adjust complete denture-upper
05411|Adjust complete denture - lower
05415|ADJUSTMENT TO PARTIAL DENTURE
05421|Adjust partial denture - upper
05422|Adjust partial denture - lower
05510|Repair broken complete denture base
05511|repair broken complete denture base, mandibular
05512|repair broken complete denture base, maxillary
05520|Replace missing or broken teeth - complete denture (each tooth)
05610|Repair resin saddle or base
05611|repair resin partial denture base, mandibular
05612|repair resin partial denture base, maxillary
05620|Repair cast framework
05621|repair cast partial framework , mandibular
05622|repair cast partial framework, maxillary
05630|Repair or replace broken clasp - per tooth
05640|Replace broken teeth - per tooth
05650|Add tooth to existing partial denture
05660|Add clasp to existing partial denture - per tooth
05670|Replace all teeth and acrylic on cast metal framework (maxillary)
05671|Replace all teeth and acrylic on cast metal framework (mandibular)
05710|Rebase complete upper denture
05711|Rebase complete lower denture
05720|Rebase upper partial denture
05721|Rebase lower partial denture
05730|Reline upper complete denture (chairside)
05731|Reline lower complete denture (chairside)
05735|USIC SPECIFIC PROCEDURE RELINE UPPER OR LOWER DENTURE
05740|Reline upper partial denture (chairside)
05741|Reline lower partial denture (chairside)
05750|Reline upper complete denture (laboratory)
05751|Reline lower complete denture (laboratory)
05755|USIC SPECIFIC PROCEDURE RELINE UPPER OR LOWER DENTURE
05760|Reline upper partial denture (laboratory)
05761|Reline lower partial denture (laboratory)
05810|Interim complete denture (upper)
05811|Interim complete denture (lower)
05820|Interim partial denture (upper)
05821|Interim partial denture (lower)
05850|Tissue conditioning, upper-per denture unit
05851|Tissue conditioning, lower-per denture unit
05860|Overdenture-complete, by report
05861|Overdenture-partial, by report
05862|Precision attachment, by report
05863|Overdenture- complete maxillary
05864|Overdenture- partial maxillary
05865|Overdenture - complete mandibular
05866|Overdunture- partial mandibular
05867|Replacement of replaceable part of semi-precision or precision attachmen
05875|Modification of removable prosthesis following implant surgery
05876|add metal substructure to acrylic full denture (per arch)
05899|Unspecified removable prosthodontic procedure, by report
05911|Facial moulage (sectional)
05912|Facial moulage (complete)
05913|Nasal prosthesis
05914|Auricular prosthesis
05915|Orbital prothesis
05916|Ocular prosthesis
05917|Composite facial prosthesis
05918|Replacement prosthesis
05919|Facial prosthesis
05920|Ocular implant
05921|Orbital implant
05922|Nasal septal prosthesis
05923|Ocular prosthesis,interim
05924|Cranial prosthesis
05925|Facial augmentation implant prosthesis
05926|Nasal prosthesis replacement
05927|Auricular prosthesis, replacement
05928|Orbital prosthesis, replacement
05929|Facial prosthesis, replacement
05931|Obturator prosthesis, surgical
05932|Obturator prosthesis, definitive
05933|Obturator prosthesis, modification
05934|Mandibular resection prosthesis with guide flange
05935|Mandibular resection prosthesis without guide flange
05936|Obturator/prosthesis, interim
05937|Trismus appliance (not for tmd treatment)
05951|Feeding aid
05952|Speech aid prosthesis, pediatric
05953|Speech aid prosthesis,adult
05954|Palatal augmentation prosthesis
05955|Palatal lift prosthesis,definitive
05956|Obturator
05957|Speech bulb
05958|Palatal lift prosthesis, interim
05959|Palatal lift prosthesis,modification
05960|Speech aid prosthesis, modification
05982|Surgical stent
05983|Radiation carrier
05984|Radiation shield
05985|Radiation cone locator
05986|Fluoride gel carrier
05987|Commissure splint
05988|Surgical splint
05991|Vesiculobullous disease medicament carrier
05992|Adult maxillofacial prosthetic by report
05993|Maintenance and cleaing of a maxillofacial prosthesis (extra  or intraoral) other than required adjustments, by report
05994|Peridontal medicament carrier with peripheral seal- laboratory processed - Deleted 2021
05995|Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary
05996|Periodontal medicament carrier with peripheral seal - laboratory processed mandibular
05999|Unspecified maxillofacial prosthesis, by report
0601|Caries risk assessment and documentation, with a finding of low risk
06010|Surgical placement of implant body:  endosteal implant
06011|Second stage implant surgery
06012|Surgical placement of interim implant body for transitional prosthesis: endosteal implant
06013|Surgical placement of mini inplant
0602|Caries risk assessment and documentation, with a finding of moderate risk
0603|Caries risk assessment and documentation, with a finding of high risk
0604|Antigen testing for a public health related pathogen includes coronavirus
06040|Subperiosteal implant
0605|Antibody testing for a public health related pathogen includes coronavirus
06050|Transasseous implant
06051|Interim abutment includes placement and removal
06052|Semi- precision attachment abutment - Deleted 2021
06053|Implant/abutment supported removable denture for completely edentulous arch
06054|Implant/abutment supported removable denture for partially edentulous arch
06055|Connecting bar - implant supported or abutment supported
06056|Prefabricated abutment-includes modification and placement
06057|Custom fabricated abutment- includes placement
06058|Abutment supported porcelain/ceramic crown
06059|Abutment supported porcelain fused to metal crown (high noble metal)
06060|Abutment supported porcelain fused to metal crown (predominantly base me
06061|Abutment supported porcelain fused to metal crown (noble metal)
06062|Abutment supported cast metal crown (high noble metal)
06063|Abutment supported cast metal crown (predominantly base metal)
06064|Abutment supported cast metal crown (noble metal)
06065|Implant supported porcelain/ceramic crown
06066|Implant supported porcelain fused to metal crown (titanium, titanium all
06067|Implant supported metal crown (titanium, titanium alloy, high noble metal)
06068|Abutment supported retainer for porcelain/ceramic fpd
06069|Abutment supported retainer for porcelain fused to metal fpd (high noble
06070|Abutment supported retainer for porcelain fused to metal fpd (predominan
06071|Abutment supported retainer for porcelain fused to metal fpd (noble meta
06072|Abutment supported retainer for cast  metal fpd (high noble metal)
06073|Abutment supported retainer for cast  metal fpd (predominantly base meta
06074|Abutment supported retainer for cast  metal fpd (noble metal)
06075|Implant supported retainer for ceramic fpd
06076|Implant supported retainer for porcelain fused to metal fpd (titanium, t
06077|Implant supported retainer for cast metal fpd (titanium, titanium alloy
06078|Implant/abutment supported fixed denture for completely edentulous arch
06079|Implant/abutment supported fixed denture for partially edentulous arch
06080|Implant maintenance procedure when prosthesis are removed and reinserted, including cleansing of prosthesis and abutments
06082|IMPL SUP CR-PRCLN FU PREDM BASE ALY
06083|IMPLANT SUPP CRWN - PORCELN FU NBL
06084|IMPLANT SUPPORTED CROWN - PORCELN F
06086|IMPLANT SUPP CRWN - PREDOM BASE ALY
06087|IMPLANT SUPP CROWN - NOBLE ALLOYS
06088|IMPLANT SUPP CROWN - TI & TI ALLOYS
06090|Repair implantsupported prosthesis by report
06091|Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis, per attachment
06092|Recement implant/abutment supported crown
06093|Recement implant/abutment supported fixed partial denture
06094|Abutment supported crown - (titanium)
06095|Repair implant abutment, by report
06096|remove broken implant retaining screw
06097|ABUT SUPP CR-PORCELN FU TI & TI ALY
06098|IMPL SUP RTN-PRCLN FU PRDM BASE ALY
06099|IMPL SUP RTN FPD-PORCELN FU NBL ALY
06100|Implant removal, by report
06101|Debridement of a periimplant defect and surface cleaning of exposed implant surfaces, including flap entry and closure
06102|Debridement and osseous contouring of a periimplant defect: includes surface cleaning of exposed implant surfaces and flap entry and closure
06103|Bone graft for repair of peri- implant defect - does not include flap entry and closure.
06104|Bone graft at time of implant placement, biologic material to aid in occeous regeneration are reported seperately
06110|Implant/ abutment supported removable denture for edentulous arch- maxillary
06111|Implant/ abutment supported removable denture for edentulous arch- mandibular
06112|Implant/ abutment supported removable denture for partially endentulous arch- maxillary
06113|Implant/ abutment supported removable denture for partially edentulous arch- mandibular
06114|Implant/ abutment supported fixed denture for edentulous arch- maxillary
06115|Implant/ abutment supported fixed denture for edentulous arch- mandibular
06116|Implant/ abutment supported fixed denture for partially edentulous arch- maxillary
06117|Implant/ abutment supported fixed denture for partially edentulous arch-mandibular
06118|implant/abutment supported interim fixed denture for edentulous arch- mandibular
06119|implant/abutment supported interim fixed denture for edentulous arch- maxillary
06120|IMPL SUP RET PRCLN FU TIT & TIT ALY
06121|IMPL SUP RET MTL FPD PREDM BASE ALY
06122|IMPL SUP RET METAL FPD - NOBLE AL
06123|IMPL SUP RET MTL FPD TIT & TIT ALY
06190|Radiographic/surgical implant index, by report
06191|Semi-precision abutment - placement
06192|Semi-precision attachment - placement
06194|Abutment supported retainer corwn for fpd - (titanium)
06195|ABUT SUP RET-PRCLN FU TIT & TIT ALY
06199|Unspecified implant procedure, by report
06205|Pontic - indirect resin based composite
06210|Pontic - cast high noble metal
06211|Pontic - cast predominantly base metal
06212|Pontic - cast noble metal
06214|Pontic titanium
06240|Pontic - porcelain fused to high noble metal
06241|Pontic - porcelain fused to predominantly base metal
06242|Pontic - porcelain fused to noble metal
06243|PONTIC - PORCELN FU TIT & TIT ALY
06245|Pontic - porcelain/ceramic
06250|Pontic-resin with high noble metal
06251|Pontic - resin with predominantly base metal
06252|Pontic - resin with noble metal
06253|Provisional pontic-futher treatment or completion of diagnosis necessary prior to final impression
06545|Retainer-cast metal for acid etched fixed prosthesis
06548|Retainer - porcelain/ceramic for resin bonded fixed prosthesis
06549|Resin retainer for resin bonded fixed prosthesis
06600|Retainer inlay - porcelain/ceramic, two surfaces
06601|Retainer inlay - porcelain/ceramic, three or more surfaces
06602|Retainer inlay - cast high noble metal, two surfaces
06603|Retainer inlay - cast high noble metal, three or more surfaces
06604|Retainer inlay - cast predominantly base metal , two surfaces
06605|Retainer inlay - cast predominantly base metal , three or more surfaces
06606|Retainer inlay - cast noble metal, two surfaces
06607|Retainer inlay - case noble metal, three or more surfaces
06608|Retainer onlay - porcelain/ceramic, two surfaces
06609|Retainer onlay - porcelain/ceramic, three or more surfaces
06610|Retainer onlay - cast high noble metal, two surfaces
06611|Retainer onlay - cast high noble metal, three or more surfaces
06612|Retainer onlay - cast predominantly base metal , two surfaces
06613|Retainer onlay - cast predominantly base metal , three or more surfaces
06614|Retainer onlay - cast noble metal, two surfaces
06615|Retainer onlay - case noble metal, three or more surfaces
06624|Retainer inlay - titanium
06634|Retainer onlay - titanium
06710|Retainer crown - indirect resin based composite
06720|Retainer crown - resin with high noble metal
06721|Retainer crown - resin with predominantly base metal
06722|Retainer crown - resin with noble metal
06740|Retainer crown - porcelain/ceramic
06750|Retainer crown - porcelain fused to high noble metal
06751|Retainer crown - porcelain fused to predominantly base metal
06752|Retainer crown - porcelain fused to noble metal
06753|RET CRWN - PORCELN FU TIT & TIT ALY
06780|Retainer crown - 3/4 cast high noble metal
06781|Retainer crown - 3/4 cast predominantly base metal
06782|Retainer crown - 3/4 cast noble metal
06783|Retainer crown - 3/4 porcelain/ceramic
06784|RETAINER CROWN 3/4 - TI & TI ALLOYS
06790|Retainer crown - full cast high noble metal
06791|Retainer crown - full cast predominantly base metal
06792|Retainer crown - full cast noble metal
06793|Provisional retainer crown- further treatment or completion of diagnosis necessary prior to final impression
06794|Retainer crown - titanium
06795|interim retainer crown
06920|Connector bar
06930|Recement bridge
06940|Stress breaker
06950|Precision attachment
06970|Post and core in addition to fix partial denture retainer, indirectly fabricated
06971|Cast post as part of fixed partial denture retainer
06972|Prefabricated post and core in addition to fixed partial denture retainer
06973|Core buildup for retainer, including any pins
06975|Coping-metal
06976|Each additional indirectly fabricated post - same tooth
06977|Each additional prefabricated post - same tooth
06980|Fixed partial denture repair, necessitated by restorative material failure
06985|Pediatric partial denture, fixed
06999|Unspecified fixed prosthodontic procedure, by report
0701|Panoramic radiographic image - image capture only
0702|2-D cephalometric radiographic image - image capture only
0703|2-D oral/facial photographic image obtained intra-orally or extra-orally - image capture only
0704|3-D photographic image - image capture only
0705|Extra-oral posterior dental radiographic image - image capture only
0706|Intraoral - occlusal radiographic image - image capture only
0707|Intraoral - periapical radiographic image - image capture only
0708|Intraoral - bitewing radiographic image - image capture only
0709|Intraoral - complete series of radiographic images - image capture only
07110|Extraction Single Tooth (deleted)
07111|Extraction, coronal remnants - deciduous tooth
07120|Extraction Each Additional Tooth(deleted)
07130|Extraction Tooth Removal(deleted)
07140|Extraction, erupted tooth or exposed root (elevation and/or forceps remo
07210|Surgical removal of erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated
07220|Removal of impacted tooth - soft tissue
07230|Removal of impacted tooth - partially bony
07240|Removal of impacted tooth - completely bony
07241|Rem.imp. tooth, completely bony, with unusual surg. complications
07250|Surgical removal of residual tooth roots (cutting procedure)
07251|Coronectomy - intentional partial tooth removal
07260|Oral antral fistula closure
07261|Primary closure of a sinus perforation
07270|Tooth reimplantation and/or stabilization of accidentally evulsed or dis
07272|Tooth transplantation
07280|Surgical access of an unerupted tooth surgical access of an unerupted to
07282|Mobilization of erupted or malpositioned tooth to aid eruption
07283|Placement of device to facilitate eruption of impacted tooth
07285|Incisional biopsy of oral tissue- hard (bone, tooth)
07286|Incisional biopsy of oral tissue - soft
07287|Exfoliative cytological sample collection
07288|Brush biopsy - transepithelial sample collection
07290|Surgical repositioning of teeth
07291|Transseptal fiberotomy/supra crestal fiberotomy, by report transseptal f
07292|Surgical placement: temporary anchorage device (screw retained plate) requiring surgical flap
07293|Surgical placement: temporary anchorage device requiring surgical flap
07294|Surgical placement: temporary anchorage device without surgical flap
07295|Harvest of bone for use in autogenous grafting procedure
07296|corticotomy - one to three teeth or tooth spaces, per quadrant
07297|corticotomy - four okr more teeth or tooth spaces, per quadrant
07310|Alveoloplasty in conjuction with extractions - four or more teeth or tooth spaces per quadrant
07311|Alveoloplasy in conjunction with extractions - one to three teeth or tooth
07320|Alveoloplasty not in conjuction with extractions - four or more teeth or tooth spaces per quadrant
07321|Alveoloplasy not in conjunction with extractions - one to three teeth or tooth
07340|Vestibuloplasty - ridge extension (second epithelialization)
07350|Vestibuloplasty - ridge extension (including soft tissue grafts
07410|Excision of benign lesion up to 1.25 cm excision of benign lesion up to
07411|Excision of benign lesion greater than 1.25 cm
07412|Excision of benign lesion, complicated
07413|Excision of malignant lesion up to 1.25 cm
07414|Excision of malignant lesion greater than 1.25 cm
07415|Excision of malignant lesion, complicated
07430|Cystectomy (<1.25cm):  Removal of  a small cyst
07431|Cystectomy (>1.25cm):  Removal of a large cyst
07440|Excision of malignant tumor - lesion diameter up to 1.25 cm
07441|Excision of malignant tumor - lesion diameter over 1.25 cm
07450|Removal of benign odontogenic cyst or tumor-lesion diameter up t0 1.25 c
07451|Removal of benign odontogenic cyst or tumor-lesion diameter greater than
07460|Removal of benign nonodontogenic cyst or tumor- lesion diameter up to 1.2
07461|Removal of benign nonodontogenic cyst or tumor- lesion diameter greater t
07465|Destruction of lesion(s) by physical methods: electrosurgery
07471|Removal of lateral exostosis (maxilla or mandible) removal of lateral ex
07472|Removal of torus palatinus
07473|Removal of torus mandibularis
07485|Surgical reduction of osseous tuberosity
07490|Radical resection of maxilla or mandible
07510|Incision and drainage of abscess - intraoral soft tissue
07511|Incision and drainage of abscess - intraoral soft tissue - complicated
07520|Incision and drainage of abscess - extraoral soft tissue
07521|Incision and drainage of abscess - extraoral soft tissue - complicated
07530|Removal of foreign body from mucosa, skin, or subcutaneous alveolar tiss
07540|Removal of reaction-producing foreign bodies - musculoskeletal
07550|Partial ostectomy/sequestrectomy for removal of non-vital bone partial o
07560|Maxillary sinusotomy for removal of tooth fragment or foreign
07610|Maxilla - open reduction (teeth immobilized if present)
07620|Maxilla - closed reduction (teeth immobilized if present)
07630|Mandible - open reduction (teeth immobilized if present)
07640|Mandible - closed reduction (teeth immobilized if present)
07650|Malar and/or zygomatic arch - open reduction
07660|Malar and/or zygomatic arch - closed reduction
07670|Alveolus - closed reduction, may include stabilization of teeth alveolus
07671|Alveolus - open reduction, may include stabilization of teeth
07680|Facial bones - complicated reduction with fixation and mul-
07710|Maxilla - open reduction
07720|Maxilla - closed reduction
07730|Mandible - open reduction
07740|Mandible - closed reduction
07750|Malar and/or zygomatic arch - open reduction
07760|Malar and/or zygomatic arch - closed reduction
07770|Alveolus - open reduction stabilization of teeth alveolus - open reducti
07771|Alveolus, closed reduction stabilization of teeth
07780|Facial bones - complicated reduction with fixation and multi-
07810|Open reduction of dislocation
07820|Closed reduction of dislocation
07830|Manipulation under anesthesia
07840|Condylectomy
07850|Surgical discectomy, with/without implant
07852|Disc repair
07854|Synovectomy
07856|Myotomy
07858|Joint reconstruction
07860|Arthrotomy
07865|Arthroplasty
07870|Arthrocentesis
07871|Non-arthroscopic lysis and lavage
07872|Arthroscopy, diagnosis,  with or without biopsy
07873|Arthroscopy-surgical:lavage and lysis of adhesions
07874|Arthroscopy -surgical:disc repositioning and stabilization
07875|Arthroscopy-surgical: synovectomy
07876|Arthroscopy-surgical:discectomy
07877|Arthroscopy- surgical:debridement
07880|Occlusal orthotic appliance
07881|Occlusal orthotic device adjustment
07899|Unspecified tmd therapy, by report
07910|Suture of recent small wounds up to 5 cm
07911|Complicated suture-up to5cm
07912|Complicated suture-greater than 5cm
07920|Skin graft (identify defect covered, location, and type of graft)
07921|Collection and application of autologous blood concentrate product
07922|PLCMT INTRA-SOC BIOL DRSG AID HEMO
07940|Osteoplasty - for orthognathic deformities
07941|Osteotomy - mandibular rami osteotomy - mandibular rami
07943|Osteotomy - mandibular rami with bone graft; includes obtaining the graf
07944|Osteotomy - segmented or subapical
07945|Osteotomy - body of mandible
07946|Lefort i (maxilla - total)
07947|Lefort i (maxilla - segmented)
07948|Lefort ii or lefort iii (osteoplasty of facial bones for midface
07949|Lefort ii or lefort iii - with bone graft
07950|Osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla - autogenous or nonautogenous, by report
07951|Sinus augmentation with bone or bone substitutes
07952|Sinus augumentation via a vertical approach
07953|Bone replacement graft for ridge preservation - per site
07955|Repair of maxillofacial soft and/or hard tissue defect
07960|Frenulectomy - also known as frenectomy or frenotomy - separate procedure not incidental to another procedure - Deleted 2021
07961|Buccal/labial frenectomy (frenulectomy)
07962|Lingual frenectomy (frenulectomy)
07963|Frenuloplasty
07970|Excision of hyperplastic tissue - per arch
07971|Excision of pericoronal gingiva
07972|Surgical reduction of fibrous tuberosity
07979|non-surgical sialolithotomy
07980|Sialolithotomy
07981|Excision of salivary gland, by report
07982|Sialodochoplasty
07983|Closure of salivary fistula
07990|Emergency tracheotomy
07991|Coronoidectomy
07992|Eminenectomy
07993|Surgical placement of craniofacial implant - extra oral
07994|Surgical placement: zygomatic implant
07995|Synthetic graft-mandible or facial bones, by report
07996|Implant-mandible for augmentation purposes (excluding alveolar ridge), b
07997|Appliance removal (not by dentist who placed appliance), includes remova
07998|Intraoral placement of a fixation device not in conjuction with a fractur
07999|Unspecified oral surgery procedure, by report
08010|Limited orthodontic treatment of the primary dentition
08020|Limited orthodontic treatment of the transitional dentition
08030|Limited orthodontic treatment of the adolescent dentition
08040|Limited orthodontic treatment of the adult dentition
08050|Interceptive orthodontic treatment of the primary dentition
08060|Interceptive orthodontic treatment of the transitional dentition
08062|Prefabricated esthetic coated stainless steel crown - primary tooth
08063|Interceptive Fixed - Clear
08070|Comprehensive orthodontic treatment of the transitional dentition
08071|Comprehensive orthodontic treatment of the transitional dentition (first six months)
08072|Comprehensive orthodontic treatment of the transitional dention (second six months)
08073|Comprehensive orthodontic treatment of the transitionaldentition (third six months)
08074|Comprehensive orthodontic treatment of the transitional dention (fourth six months)
08080|Comprehensive orthodontic treatment of the adolescent dentition
08081|Comprehensive orthodontic treatment of the adolescent dentition (first six months)
08082|Comprehensive orthodontic treatment of the adolescent dentition (second six months)
08083|Comprehensive orthodontic treatment of the adolescent dentition (third six months)
08084|Comprehensive orthodontic treatment of the adolescent dentition (fourth six months)
08090|Comprehensive orthodontic treatment of the adult dentition
08091|Comprehensive orthodontic treatment of the adult dentition (first six months)
08092|Comprehensive orthodontic treatment of the adult dentition (second six months)
08093|Comprehensive orthodontic treatment of the adult dentition (third six months)
08094|Comprehensive orthodontic treatment of the adult dentition (fourth six months)
08110|Orthodontic Rem Appliance Tx
08120|Fixed Appliance Therapy Guid
08210|Removable appliance therapy
08220|Fixed appliance therapy
08360|Orthodontic Rem Appliance Tx
08370|Fixed Appliance Interceptive
08460|Trans Dentit Class 1 Maloccl
08470|Class II Malocclusion Trnstn
08480|Class III Malocclusion Trnst
08560|Class I Tx Atyp/Ext Skel CAS
08570|Class II Malocclusion Perman
08580|Class III Malocclusion Permn
08650|Tx Atypical/Extend Skel Case
08660|Pre-orthodontic visit
08670|Periodic orthodontic treatment visit
08680|Orthodontic retention (removal of appliances, construction and placement
08681|Removable orthodontic retainer adjustment
08690|Orthodontic treatment (alternative billing to a contract fee)
08691|Repair of orthodontic appliance
08692|Replacement of lost or broken retainer
08693|Re-cement or re-bond fixed retainers
08694|Repair of fixed retainers, includes reattachment
08695|removal of fixed orthodontic appliances for reasons other than completion of treatment
08696|REPAIR ORTHODONTIC APPLIANCE - MAX
08697|REPAIR ORTHODONTIC APPLIANCE - MAND
08698|RE-CEMENT/RE-BOND FIX RETAIN - MAX
08699|RE-CEMENT/RE-BOND FIX RETAIN - MAND
08701|REPR FIX RETAIN INCL REATTACH - MAX
08702|REPR FIX RETAIN INCL REATTCH - MAND
08703|REPL LOST/BROKEN RETAINER - MAX
08704|REPL LOST/BROKEN RETAINER - MAND
08750|Post-Treatment Stabilization
08999|Unspecified orthodontic procedure, by report
09110|Palliative (emergency) treatment of dental pain - minor procedures
09120|Fixed partial denture sectioning
09130|temporomandibular joint dysfunction noninvasive physical therapies.
09210|Local anesthesia  not in conjunction with operative or surgical
09211|Regional block anesthesia
09212|Trigeminal division block anesthesia
09215|Local anesthesia in conjunction with operative or surgical procedures
09219|Evaluation for moderate sedation, deep sedation or general anesthesia
09220|General anesthesia-first 30 minutes
09221|General anesthesia-each additional 15 minutes
09222|deep sedation/general anesthesia  first 15 minutes
09223|Deep sedation/general anesthesia - each 15 minute increment
09230|Inhalation of nitrous oxide / anxiolysis, analgesia
09239|intravenous moderate (conscious) sedation/analgesia  first 15 minutes
09241|Intravenous conscious sedation/analgesia  first 30 minutes (parenteral sedation)
09242|Intravenous conscious sedation/analgesia  each additional 15 minutes (parenteral sedation)
09243|Intravenous moderate (conscious) sedation/analgesia - each 15  minute increment
09248|Non-intravenous (conscious) sedation
09310|Consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician
09410|House/extended care facility call house/extended care facility call
09420|Hospital or amublatory surgical center call
09430|Office visit for observation (during regularly scheduled hours)
09440|Office visit - after regularly scheduled hours
09450|Case presentation, detailed and extensive treatment planning
09610|Therapeutic parenteral drug, single administration
09612|Therapeutic parenteral drugs, two or more administrations, different medications
09613|infiltration of sustained release therapeutic drug G?? single or multiple sites.
09630|Other drugs and/or medicaments, by report
09910|Application of desensitizing medicaments
09911|Application of desensitizing resin for cervical and/or root surface, per
09920|Behavior management, by report
09930|Treatment of complications (postsurgical) - unusual
09931|Cleaning and inspection of a removable appliance
09932|Cleaning and inspection of removable complete denture, maxillary
09933|Cleaning and inspection of removable complete denture, mandibular
09934|Cleaning and inspection of removable partial denture, maxillary
09935|Cleaning and inspection of removable partial denture, mandibular
09940|Occlusal guards, by report (2019 Deletion)
09941|Fabrication of athletic mouthguards
09942|Repair and/or reline of occlusal guard
09943|Occlusal guard adjustment
09944|Occlusal guard - hard appliance, full arch (Replaces D9940 Occlusal guard)
09945|occlusal guard soft appliance, full arch.
09946|occlusal guard hard appliance, partial arch.
09950|Occlusion analysis - mounted case
09951|Occlusal adjustment - limited
09952|Occlusal adjustment - complete
09961|duplicate/copy patient records
09970|Enamel microabrasion
09971|Odontoplasty 1 - 2 teeth; includes removal of enamel projections
09972|External bleaching  - per arch
09973|External bleaching - per tooth
09974|Internal bleaching - per tooth
09975|External bleaching for home application, per arch; includes materials and fabrication of custom trays
09985|Sales tax
09986|Missed appointment
09987|Cancelled appointment
0999|Unspecified diagnostic procedure, by report
09990|certified translation or sign-language services per visit
09991|Case mgmt, appt barriers
09992|Case mgmt, care coordination
09993|Case mgmt, interviewing
09994|Case mgmt, pt education
09995|teledentistry  synchronous; real-time encounter
09996|teledentistry  asynchronous; information stored and forwarded to dentist for subsequent review
09997|DENTAL CASE MGMT-PTS SPCL HC NEEDS
09998|Unspecified miscellaneous service procedure
09999|Unspecified adjunctive procedure, by report
1110|Prophylaxis - adult
1120|Prophylaxis - child
1201|Topical Application of Fluoride (Including Prophylaxis)- Child
1203|Topical application of fluoride (prophylaxis not included)child (under 21 years of age)
1204|Topical application of fluoride (prophylaxis not included)adult (21 years of age and older)
1205|topical application of flouride (including prophylasix) -adult
1206|Topical application of fluoride varnish
1208|Topical application of fluoride
1310|Nutritional counseling for the control of dental disease
1320|Tobacco counseling for the control and prevention of oral disease
1321|Counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use
1330|Oral hygiene instruction
1351|Sealant - per tooth
1352|Preventative resin restoration in a moderat to high caries risk patient-permanent tooth
1353|Sealant repair- per tooth
1354|Intermin caries arresting medicament application
1355|Caries preventive medicament application - per tooth
1510|Space maintainer - fixed-unilateral
1515|Space maintainer - fixed-bilateral (2019 deletion)
1516|space maintainer fixed bilateral, maxillary
1517|space maintainer fixed bilateral, mandibular
1520|Space maintainer - removable- unilateral
1525|Space maintainer - removable- bilateral (2019 deletion)
1526|SPACE MAINTAIN- REMOVE-BILAT, MAXIL
1527|space maintainer removable bilateral, mandibular
1550|Re-cement or re-bond space maintainer
1551|RE-CEM/RE-BOND BIL SPACE MNTNR-MAX
1552|RE-CEM/RE-BOND BIL SPC MNTNR - MAND
1553|RE-CEM/RE-BOND UNI SPACE MNTNR-QUAD
1555|Removal of fixed spacer maintainer
1556|REMV FIX UNI SPACE MNTNR - PER QUAD
1557|REMOVAL FIXED BIL SPACE MNTNR - MAX
1558|REMOVAL FIX BIL SPACE MNTNR - MAND
1999|Unspecified preventive procedure, by report
2140|Amalgam-one surface, primary or permanent amalgam-one surface, primary o
2150|Amalgam-two surfaces, primary or permanent amalgam-two surfaces, primary
2160|Amalgam-three surfaces, primary or permanent amalgam-three surfaces, pri
2161|Amalgam-four or more surfaces, primary or permanent amalgam- four or more
2222|Onlay-resin-based composite-four or more surfaces
2330|Resin-one surface, anterior
2331|Resin-two surfaces, anterior
2332|Resin-three surfaces, anterior
2335|Resin-four or more surfaces on involving incisal angle
2390|Resin-based composite crown, anterior
2391|Resin-based composite - one surface, posterior
2392|Resin-based composite - two surfaces, posterior
2393|Resin-based composite - three surfaces, posterior
2394|Resin-based composite - four or more surfaces, posterior
2410|Gold foil - one surface
2420|Gold foil - two surfaces
2430|Gold foil - three surfaces
2510|Inlay - metallic - one surface
2520|Inlay - metallic -two surfaces
2530|Inlay - metallic - three  surfaces
2542|Onlay-metallic-two surfaces
2543|Onlay - metallic - three surfaces
2544|Onlay - metallic - four or more surfaces
2610|Inlay - porcelain/ceramic - one surface
2620|Inlay - porcelain/ceramic-two surfaces
2630|Inlay - porcelain/ceramic-three surfaces
2642|Onlay - porcelain/ceramic - two surfaces
2643|Onlay - porcelain/ceramic - three surfaces
2644|Onlay - porcelain/ceramic - four or more surfaces
2650|Inlay - resin-based composite - one surface inlay - resin-based composit
2651|Inlay - resin-based composite - two surfaces inlay - resin-based composi
2652|Inlay - resin-based composite - three or more surfaces inlay - resin-bas
2662|Onlay - resin-based composite - two surfaces onlay - resin-based composi
2663|Onlay - resin-based composite - three surfaces onlay - resin- based compo
2664|Onlay - - resin-based composite - four or more surfaces onlay - - resin-
2710|Crown-resin-based composite (indirect)
2712|Crown - 3/4 resin-based composite (indirect)
2720|Crown-resin with high noble metal
2721|Crown-resin with predominantly base metal
2722|Crown-resin with noble metal
2740|Crown-porcelain/ceramic substrate
2750|Crown-porcelain fused to high noble metal
2751|Crown-procelain fused to predominantly base metal
2752|Crown-porcelain fused to noble metal
2753|CRWN - PORCLN FUSD TO TIT & TIT ALY
2780|Crown - 3/4 cast high noble metal
2781|Crown - 3/4 cast predominantly base metal
2782|Crown - 3/4 cast noble metal
2783|Crown - 3/4 porcelain/ceramic
2790|Crown - full cast high noble metal
2791|Crown - full cast predominantly base metal
2792|Crown - full cast noble metal
2794|Crown-titanium
2799|Provisional crown-further treatment or completion of diagnosis necessary prior to final impression
2910|Recement inlay, onlay or partial coverage restoration
2915|Recement cast or prefabricated post and core
2920|Recement crown
2921|Reattachment of tooth fragment, incisal edge or cusp
2928|Prefabricated porcelain/ceramic crown - permanent tooth
2929|Prefabricated porcelain/ceramic crown-primary tooth
2930|Prefabricated stainless steel crown - primary tooth
2931|Prefabricated stainless steel crown - permanent tooth
2932|Prefabricated resin crown
2933|Prefabricated stainless steel crown with resin window
2934|Prefabricated esthetic coated stainless steel crown - primary tooth
2940|Protective restoration post removal
2941|Interim therapeutic restoration- primary dentition
2949|Restorative foundation for an indirect restoration
2950|Core buildup, including any pins when required
2951|Pin retention - per tooth, in addition to restoration
2952|Post and core in addition to crown, indirectly fabricated
2953|Each additional indirectly fabricated post - same tooth
2954|Prefabricated post and core in addition to crown
2955|Post removal (not in conjuction with endodontic therapy)
2957|Each additional prefabricated post - same tooth
2960|Labial veneer (laminate)-chairside
2961|Labial veneer (resin laminate)- laboratory
2962|Labial veneer (porcelain laminate)- laboratory
2970|Temporary crown (fractured tooth)
2971|Additional procedures to construct new crown under existing partial denture
2975|Coping
2980|Crown repair necessitated by restorative material failure
2981|Inlay repair necessitaed by restorative material failure
2982|Onlay repair necessitated by restorative material failure
2983|Vaneer repair necessitated by restorative material failure
2990|Resin infiltration of incipient smooth surface lesions
2999|Unspecified restorative procedure, by report
3110|Pulp cap - direct (excluding final restoration)
3120|Pulp cap -indirect  (excluding final restoration)
3220|Therapeutic pulpotomy (excluding final restoration)  removal of pulp cor
3221|Pulpal debridement, primary and permanent teeth pulpal debridement, prim
3222|Partial pulpotomy for apexogenesis - permanent tooth with incompleted root development
3230|Pulpal therapy (resorbable filling)-anterior, primary tooth (excluding f
3240|Pulpal therapy (resorbable filling)-posterior, primary tooth (excluding
3310|Endodontic therapy, anterior tooth (excluding final restoration)
3320|Endodontic therapy, bicuspid tooth (excluding final restoration)
3330|Endodontic therapy, molar (excluding final restoration)
3331|Treatment of root canal obstruction; non-surgical access
3332|Incomplete endodontic therapy; inoperable, unrestorable or fractured tooth
3333|Internal root repair of perforation defects
3346|Retreatment-anterior, by report
3347|Retreatment-bicuspid, by report
3348|Retreatment-molar, by report
3351|Apexification/ recalcification- initial visit (apical closure/ calcific repair of perforations, root resorption, pulp space disinfection, etc.)
3352|Apexification/recalcification- interim medication replacement
3353|Apexification/recalcification-final visit (includes completed root canal
3355|Pulpal regeneration- initial visit
3356|Pulpal regeneration- interim medication replacement
3357|Pulpal regeneration- completion of treatment
3410|Apicoectomy- anterior
3421|Apicoectomy- bicuspid (first root)
3425|Apicoectomy- molar (first root)
3426|Apicoectomy- each additional root
3427|Periradicular surgery without apicoectomy - Deleted 2021
3428|Bone graft in conjunction with periradicular surgery- per tooth, single site
3429|Bone graft in conjunction with periradicular surgery- each additional contiguous tooth in the same surgical site
3430|Retrograde filling - per root
3431|Biological material to aid in soft and osseous tissue regeneration in conjunction with periradicular surgery
3432|Guided tissue regeneration, resorbable barrier, per site, in conjuction with periradicular surgery
3450|Root amputation - per root
3460|Endodontic endosseous implant
3470|Intentional replantation (including necessary splinting)
3471|Surgical repair of root resorption - anterior
3472|Surgical repair of root resorption - premolar
3473|Surgical repair of root resorption - molar
3501|Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior
3502|Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar
3503|Surgical exposure of root surface without apicoectomy or repair of root resorption - molar
3910|Surgical procedure for isolation of tooth with rubber dam
3920|Hemisection (including any root removal), not including root canal thera
3950|Canal preparation and fitting of preformed dowel or post
3999|Unspecified endodontic procedure, by report
4210|Gingivectomy or gingivoplasty- four or more contiguous teeth or tooth bounded spaces per quadrant, performed to eliminate suprabony pockets
4211|Gingivectomy or gingivoplasty one to three contiguous teeth or tooth bounded spaces per quadrant
4212|Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth
4230|Anatomical crown exposure - four or more contiguous teeth per quadrant
4231|Anatomical crown exposure - ont to three teeth per quadrant
4240|Gingival flap procedure including root planning - four or more continguous teeth or tooth bounded spaces per quadrant
4241|Gingival flap procedure including root planning - one to three continguous teeth or tooth bounded spaces per quadrant
4245|Apically positioned flap
4249|Crown lengthening-hard and soft tissue, by report
4260|Osseous surgery (including elevation of a full thickness flap and closure)- four or more contiguous teeth or tooth bounded space per quandrant
4261|Osseous surgery (including elevation of a  full thickness flap and closure)- one to three contiguous teeth or tooth bounded spaces per quandrant
4263|Bone replacement graft - first site in quadrant
4264|Bone replacement graft - each additional site in quadrant
4265|Biologic materials to aid in soft and osseous tissue regeneration
4266|Guided tissue regeneration- resorbable barrier, per site
4267|Guided tissue regeneration-non- resorbable barrier, per site (includes membrane removal)
4268|Surgical revision procedure, per tooth
4270|Pedicle soft tissue graft procedure
4271|Free soft tissue graft procedure (including donor site surgery)
4272|Apically repositioning flap procedure
4273|Autogenous connective tissue graft procedures (including donor and recipient surgical sites) first tooth, implant, or edentulous tooth position in graft
4274|Distal or proximal wedge procedure (when not performed in conjuction wit
4275|Non-autogenous connective tissue graft (including recipient site and donor material) first tooth, implant, or edentulous tooth position in graft
4276|Combined connective tissue and double pedicle graft, per tooth
4277|Free soft tissue graft procedure (including recipient and donor surgical sites) first tooth, implant, or edentulous tooth position in graft
4278|Free soft tissue graft procedure (including recipient and donor surgical sites) each additional tooth, implant, or edentulous tooth position in graft
4283|Autogenous connective tissue graft procedure (including donor and recipient surgical sites) - each additional contiguous tooth, implant or edentulous tooth position in same graft site
4285|Non-autogenous connective tissue graft procedure (including recipient surgical site and donor material) - each additional contiguous tooth, implant or edentulous tooth postiiion in same graft site
4320|Provisional splinting - intracoronal
4321|Provisional splinting - extracoronal
4341|Periodontal scaling and root planing - four or more teeth per quadrant
4342|Periodontal scaling and root planing - one to three teeth, per quadrant
4355|Full mouth debridement to enable comprehensive evaluation and diagnosis
4381|Localized delivery of antimicrobial via a controlled release vehicle into diseased crevicular tissue per tooth
4910|Periodontal maintenance periodontal maintenance
4920|Unscheduled dressing change (by someone other than treating dentist)
4921|Gingival irrigation- per quadrant
4999|Unspecified periodontal procedure, by report
5110|Complete upper
5120|Complete lower
5130|Immediate upper
5140|Immediate lower
5211|maxillary partial denture-resin base (including any conventional clasps, rests and t
5212|mandibular partial denture-resin base (including any conventional clasps, rests and t
5213|Upper partial-cast metal base with resin saddles (including any conventi
5214|Lower partial-cast metal base with resin saddles (including any conventi
5221|Immediate maxillary partial denture- resin base (including any conventional clasps, rests, and teeth)
5222|Immediate mandibular partial denture- resin base (including any conventional clasps, rests, and teeth)
5223|Immediate maxillary partial denture- cast metal framework with resin denture bases (including any conventional clasps, rests, and teeth)
5224|Immediate mandibular partial denture- cast metal framework with resin denture bases (including any conventional clasps, rests, and teeth)
5225|Maxillary partial denture - flexible base (including any clasps, rests and
5226|Mandibular partial denture - flexible base (including any clasps, rests and
5227|Immediate maxillary partial denture - flexible base (including any clasps, rests and teeth) Covered once in a seven year period.
5228|Immediate mandibular partial denture - flexible base (including any clasps, rests and teeth)
5281|Removable unilateral partial denture-one piece cast metal  (2019 Deletion)
5282|removable unilateral partial denture one-piece cast metal (including clasps and teeth), maxillary
5283|removable unilateral partial denture one-piece cast metal (including clasps and teeth), mandibular
5284|REMV UNI PRTL D 1 PC FLEX BASE QUAD
5286|REM UNI PRTL D - 1 PC RESIN - QUAD
5410|Adjust complete denture-upper
5411|Adjust complete denture - lower
5415|ADJUSTMENT TO PARTIAL DENTURE
5421|Adjust partial denture - upper
5422|Adjust partial denture - lower
5510|Repair broken complete denture base
5511|repair broken complete denture base, mandibular
5512|repair broken complete denture base, maxillary
5520|Replace missing or broken teeth - complete denture (each tooth)
5610|Repair resin saddle or base
5611|repair resin partial denture base, mandibular
5612|repair resin partial denture base, maxillary
5620|Repair cast framework
5621|repair cast partial framework , mandibular
5622|repair cast partial framework, maxillary
5630|Repair or replace broken clasp - per tooth
5640|Replace broken teeth - per tooth
5650|Add tooth to existing partial denture
5660|Add clasp to existing partial denture - per tooth
5670|Replace all teeth and acrylic on cast metal framework (maxillary)
5671|Replace all teeth and acrylic on cast metal framework (mandibular)
5710|Rebase complete upper denture
5711|Rebase complete lower denture
5720|Rebase upper partial denture
5721|Rebase lower partial denture
5730|Reline upper complete denture (chairside)
5731|Reline lower complete denture (chairside)
5735|USIC SPECIFIC PROCEDURE RELINE UPPER OR LOWER DENTURE
5740|Reline upper partial denture (chairside)
5741|Reline lower partial denture (chairside)
5750|Reline upper complete denture (laboratory)
5751|Reline lower complete denture (laboratory)
5755|USIC SPECIFIC PROCEDURE RELINE UPPER OR LOWER DENTURE
5760|Reline upper partial denture (laboratory)
5761|Reline lower partial denture (laboratory)
5810|Interim complete denture (upper)
5811|Interim complete denture (lower)
5820|Interim partial denture (upper)
5821|Interim partial denture (lower)
5850|Tissue conditioning, upper-per denture unit
5851|Tissue conditioning, lower-per denture unit
5860|Overdenture-complete, by report
5861|Overdenture-partial, by report
5862|Precision attachment, by report
5863|Overdenture- complete maxillary
5864|Overdenture- partial maxillary
5865|Overdenture - complete mandibular
5866|Overdunture- partial mandibular
5867|Replacement of replaceable part of semi-precision or precision attachmen
5875|Modification of removable prosthesis following implant surgery
5876|add metal substructure to acrylic full denture (per arch)
5899|Unspecified removable prosthodontic procedure, by report
5911|Facial moulage (sectional)
5912|Facial moulage (complete)
5913|Nasal prosthesis
5914|Auricular prosthesis
5915|Orbital prothesis
5916|Ocular prosthesis
5917|Composite facial prosthesis
5918|Replacement prosthesis
5919|Facial prosthesis
5920|Ocular implant
5921|Orbital implant
5922|Nasal septal prosthesis
5923|Ocular prosthesis,interim
5924|Cranial prosthesis
5925|Facial augmentation implant prosthesis
5926|Nasal prosthesis replacement
5927|Auricular prosthesis, replacement
5928|Orbital prosthesis, replacement
5929|Facial prosthesis, replacement
5931|Obturator prosthesis, surgical
5932|Obturator prosthesis, definitive
5933|Obturator prosthesis, modification
5934|Mandibular resection prosthesis with guide flange
5935|Mandibular resection prosthesis without guide flange
5936|Obturator/prosthesis, interim
5937|Trismus appliance (not for tmd treatment)
5951|Feeding aid
5952|Speech aid prosthesis, pediatric
5953|Speech aid prosthesis,adult
5954|Palatal augmentation prosthesis
5955|Palatal lift prosthesis,definitive
5956|Obturator
5957|Speech bulb
5958|Palatal lift prosthesis, interim
5959|Palatal lift prosthesis,modification
5960|Speech aid prosthesis, modification
5982|Surgical stent
5983|Radiation carrier
5984|Radiation shield
5985|Radiation cone locator
5986|Fluoride gel carrier
5987|Commissure splint
5988|Surgical splint
5991|Vesiculobullous disease medicament carrier
5992|Adult maxillofacial prosthetic by report
5993|Maintenance and cleaing of a maxillofacial prosthesis (extra  or intraoral) other than required adjustments, by report
5994|Peridontal medicament carrier with peripheral seal- laboratory processed - Deleted 2021
5995|Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary
5996|Periodontal medicament carrier with peripheral seal - laboratory processed mandibular
5999|Unspecified maxillofacial prosthesis, by report
6010|Surgical placement of implant body:  endosteal implant
6011|Second stage implant surgery
6012|Surgical placement of interim implant body for transitional prosthesis: endosteal implant
6013|Surgical placement of mini inplant
6040|Subperiosteal implant
6050|Transasseous implant
6051|Interim abutment includes placement and removal
6052|Semi- precision attachment abutment - Deleted 2021
6053|Implant/abutment supported removable denture for completely edentulous arch
6054|Implant/abutment supported removable denture for partially edentulous arch
6055|Connecting bar - implant supported or abutment supported
6056|Prefabricated abutment-includes modification and placement
6057|Custom fabricated abutment- includes placement
6058|Abutment supported porcelain/ceramic crown
6059|Abutment supported porcelain fused to metal crown (high noble metal)
6060|Abutment supported porcelain fused to metal crown (predominantly base me
6061|Abutment supported porcelain fused to metal crown (noble metal)
6062|Abutment supported cast metal crown (high noble metal)
6063|Abutment supported cast metal crown (predominantly base metal)
6064|Abutment supported cast metal crown (noble metal)
6065|Implant supported porcelain/ceramic crown
6066|Implant supported porcelain fused to metal crown (titanium, titanium all
6067|Implant supported metal crown (titanium, titanium alloy, high noble metal)
6068|Abutment supported retainer for porcelain/ceramic fpd
6069|Abutment supported retainer for porcelain fused to metal fpd (high noble
6070|Abutment supported retainer for porcelain fused to metal fpd (predominan
6071|Abutment supported retainer for porcelain fused to metal fpd (noble meta
6072|Abutment supported retainer for cast  metal fpd (high noble metal)
6073|Abutment supported retainer for cast  metal fpd (predominantly base meta
6074|Abutment supported retainer for cast  metal fpd (noble metal)
6075|Implant supported retainer for ceramic fpd
6076|Implant supported retainer for porcelain fused to metal fpd (titanium, t
6077|Implant supported retainer for cast metal fpd (titanium, titanium alloy
6078|Implant/abutment supported fixed denture for completely edentulous arch
6079|Implant/abutment supported fixed denture for partially edentulous arch
6080|Implant maintenance procedure when prosthesis are removed and reinserted, including cleansing of prosthesis and abutments
6082|IMPL SUP CR-PRCLN FU PREDM BASE ALY
6083|IMPLANT SUPP CRWN - PORCELN FU NBL
6084|IMPLANT SUPPORTED CROWN - PORCELN F
6086|IMPLANT SUPP CRWN - PREDOM BASE ALY
6087|IMPLANT SUPP CROWN - NOBLE ALLOYS
6088|IMPLANT SUPP CROWN - TI & TI ALLOYS
6090|Repair implantsupported prosthesis by report
6091|Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis, per attachment
6092|Recement implant/abutment supported crown
6093|Recement implant/abutment supported fixed partial denture
6094|Abutment supported crown - (titanium)
6095|Repair implant abutment, by report
6096|remove broken implant retaining screw
6097|ABUT SUPP CR-PORCELN FU TI & TI ALY
6098|IMPL SUP RTN-PRCLN FU PRDM BASE ALY
6099|IMPL SUP RTN FPD-PORCELN FU NBL ALY
6100|Implant removal, by report
6101|Debridement of a periimplant defect and surface cleaning of exposed implant surfaces, including flap entry and closure
6102|Debridement and osseous contouring of a periimplant defect: includes surface cleaning of exposed implant surfaces and flap entry and closure
6103|Bone graft for repair of peri- implant defect - does not include flap entry and closure.
6104|Bone graft at time of implant placement, biologic material to aid in occeous regeneration are reported seperately
6110|Implant/ abutment supported removable denture for edentulous arch- maxillary
6111|Implant/ abutment supported removable denture for edentulous arch- mandibular
6112|Implant/ abutment supported removable denture for partially endentulous arch- maxillary
6113|Implant/ abutment supported removable denture for partially edentulous arch- mandibular
6114|Implant/ abutment supported fixed denture for edentulous arch- maxillary
6115|Implant/ abutment supported fixed denture for edentulous arch- mandibular
6116|Implant/ abutment supported fixed denture for partially edentulous arch- maxillary
6117|Implant/ abutment supported fixed denture for partially edentulous arch-mandibular
6118|implant/abutment supported interim fixed denture for edentulous arch- mandibular
6119|implant/abutment supported interim fixed denture for edentulous arch- maxillary
6120|IMPL SUP RET PRCLN FU TIT & TIT ALY
6121|IMPL SUP RET MTL FPD PREDM BASE ALY
6122|IMPL SUP RET METAL FPD - NOBLE AL
6123|IMPL SUP RET MTL FPD TIT & TIT ALY
6190|Radiographic/surgical implant index, by report
6191|Semi-precision abutment - placement
6192|Semi-precision attachment - placement
6194|Abutment supported retainer corwn for fpd - (titanium)
6195|ABUT SUP RET-PRCLN FU TIT & TIT ALY
6199|Unspecified implant procedure, by report
6205|Pontic - indirect resin based composite
6210|Pontic - cast high noble metal
6211|Pontic - cast predominantly base metal
6212|Pontic - cast noble metal
6214|Pontic titanium
6240|Pontic - porcelain fused to high noble metal
6241|Pontic - porcelain fused to predominantly base metal
6242|Pontic - porcelain fused to noble metal
6243|PONTIC - PORCELN FU TIT & TIT ALY
6245|Pontic - porcelain/ceramic
6250|Pontic-resin with high noble metal
6251|Pontic - resin with predominantly base metal
6252|Pontic - resin with noble metal
6253|Provisional pontic-futher treatment or completion of diagnosis necessary prior to final impression
6545|Retainer-cast metal for acid etched fixed prosthesis
6548|Retainer - porcelain/ceramic for resin bonded fixed prosthesis
6549|Resin retainer for resin bonded fixed prosthesis
6600|Retainer inlay - porcelain/ceramic, two surfaces
6601|Retainer inlay - porcelain/ceramic, three or more surfaces
6602|Retainer inlay - cast high noble metal, two surfaces
6603|Retainer inlay - cast high noble metal, three or more surfaces
6604|Retainer inlay - cast predominantly base metal , two surfaces
6605|Retainer inlay - cast predominantly base metal , three or more surfaces
6606|Retainer inlay - cast noble metal, two surfaces
6607|Retainer inlay - case noble metal, three or more surfaces
6608|Retainer onlay - porcelain/ceramic, two surfaces
6609|Retainer onlay - porcelain/ceramic, three or more surfaces
6610|Retainer onlay - cast high noble metal, two surfaces
6611|Retainer onlay - cast high noble metal, three or more surfaces
6612|Retainer onlay - cast predominantly base metal , two surfaces
6613|Retainer onlay - cast predominantly base metal , three or more surfaces
6614|Retainer onlay - cast noble metal, two surfaces
6615|Retainer onlay - case noble metal, three or more surfaces
6624|Retainer inlay - titanium
6634|Retainer onlay - titanium
6710|Retainer crown - indirect resin based composite
6720|Retainer crown - resin with high noble metal
6721|Retainer crown - resin with predominantly base metal
6722|Retainer crown - resin with noble metal
6740|Retainer crown - porcelain/ceramic
6750|Retainer crown - porcelain fused to high noble metal
6751|Retainer crown - porcelain fused to predominantly base metal
6752|Retainer crown - porcelain fused to noble metal
6753|RET CRWN - PORCELN FU TIT & TIT ALY
6780|Retainer crown - 3/4 cast high noble metal
6781|Retainer crown - 3/4 cast predominantly base metal
6782|Retainer crown - 3/4 cast noble metal
6783|Retainer crown - 3/4 porcelain/ceramic
6784|RETAINER CROWN 3/4 - TI & TI ALLOYS
6790|Retainer crown - full cast high noble metal
6791|Retainer crown - full cast predominantly base metal
6792|Retainer crown - full cast noble metal
6793|Provisional retainer crown- further treatment or completion of diagnosis necessary prior to final impression
6794|Retainer crown - titanium
6795|interim retainer crown
6920|Connector bar
6930|Recement bridge
6940|Stress breaker
6950|Precision attachment
6970|Post and core in addition to fix partial denture retainer, indirectly fabricated
6971|Cast post as part of fixed partial denture retainer
6972|Prefabricated post and core in addition to fixed partial denture retainer
6973|Core buildup for retainer, including any pins
6975|Coping-metal
6976|Each additional indirectly fabricated post - same tooth
6977|Each additional prefabricated post - same tooth
6980|Fixed partial denture repair, necessitated by restorative material failure
6985|Pediatric partial denture, fixed
6999|Unspecified fixed prosthodontic procedure, by report
7110|Extraction Single Tooth (deleted)
7111|Extraction, coronal remnants - deciduous tooth
7120|Extraction Each Additional Tooth(deleted)
7130|Extraction Tooth Removal(deleted)
7140|Extraction, erupted tooth or exposed root (elevation and/or forceps remo
7210|Surgical removal of erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated
7220|Removal of impacted tooth - soft tissue
7230|Removal of impacted tooth - partially bony
7240|Removal of impacted tooth - completely bony
7241|Rem.imp. tooth, completely bony, with unusual surg. complications
7250|Surgical removal of residual tooth roots (cutting procedure)
7251|Coronectomy - intentional partial tooth removal
7260|Oral antral fistula closure
7261|Primary closure of a sinus perforation
7270|Tooth reimplantation and/or stabilization of accidentally evulsed or dis
7272|Tooth transplantation
7280|Surgical access of an unerupted tooth surgical access of an unerupted to
7282|Mobilization of erupted or malpositioned tooth to aid eruption
7283|Placement of device to facilitate eruption of impacted tooth
7285|Incisional biopsy of oral tissue- hard (bone, tooth)
7286|Incisional biopsy of oral tissue - soft
7287|Exfoliative cytological sample collection
7288|Brush biopsy - transepithelial sample collection
7290|Surgical repositioning of teeth
7291|Transseptal fiberotomy/supra crestal fiberotomy, by report transseptal f
7292|Surgical placement: temporary anchorage device (screw retained plate) requiring surgical flap
7293|Surgical placement: temporary anchorage device requiring surgical flap
7294|Surgical placement: temporary anchorage device without surgical flap
7295|Harvest of bone for use in autogenous grafting procedure
7296|corticotomy - one to three teeth or tooth spaces, per quadrant
7297|corticotomy - four or more teeth or tooth spaces, per quadrant
7310|Alveoloplasty in conjuction with extractions - four or more teeth or tooth spaces per quadrant
7311|Alveoloplasy in conjunction with extractions - one to three teeth or tooth
7320|Alveoloplasty not in conjuction with extractions - four or more teeth or tooth spaces per quadrant
7321|Alveoloplasy not in conjunction with extractions - one to three teeth or tooth
7340|Vestibuloplasty - ridge extension (second epithelialization)
7350|Vestibuloplasty - ridge extension (including soft tissue grafts
7410|Excision of benign lesion up to 1.25 cm excision of benign lesion up to
7411|Excision of benign lesion greater than 1.25 cm
7412|Excision of benign lesion, complicated
7413|Excision of malignant lesion up to 1.25 cm
7414|Excision of malignant lesion greater than 1.25 cm
7415|Excision of malignant lesion, complicated
7430|Cystectomy (<1.25cm):  Removal of  a small cyst
7431|Cystectomy (>1.25cm):  Removal of a large cyst
7440|Excision of malignant tumor - lesion diameter up to 1.25 cm
7441|Excision of malignant tumor - lesion diameter over 1.25 cm
7450|Removal of benign odontogenic cyst or tumor-lesion diameter up t0 1.25 c
7451|Removal of benign odontogenic cyst or tumor-lesion diameter greater than
7460|Removal of benign nonodontogenic cyst or tumor- lesion diameter up to 1.2
7461|Removal of benign nonodontogenic cyst or tumor- lesion diameter greater t
7465|Destruction of lesion(s) by physical methods: electrosurgery
7471|Removal of lateral exostosis (maxilla or mandible) removal of lateral ex
7472|Removal of torus palatinus
7473|Removal of torus mandibularis
7485|Surgical reduction of osseous tuberosity
7490|Radical resection of maxilla or mandible
7510|Incision and drainage of abscess - intraoral soft tissue
7511|Incision and drainage of abscess - intraoral soft tissue - complicated
7520|Incision and drainage of abscess - extraoral soft tissue
7521|Incision and drainage of abscess - extraoral soft tissue - complicated
7530|Removal of foreign body from mucosa, skin, or subcutaneous alveolar tiss
7540|Removal of reaction-producing foreign bodies - musculoskeletal
7550|Partial ostectomy/sequestrectomy for removal of non-vital bone partial o
7560|Maxillary sinusotomy for removal of tooth fragment or foreign
7610|Maxilla - open reduction (teeth immobilized if present)
7620|Maxilla - closed reduction (teeth immobilized if present)
7630|Mandible - open reduction (teeth immobilized if present)
7640|Mandible - closed reduction (teeth immobilized if present)
7650|Malar and/or zygomatic arch - open reduction
7660|Malar and/or zygomatic arch - closed reduction
7670|Alveolus - closed reduction, may include stabilization of teeth alveolus
7671|Alveolus - open reduction, may include stabilization of teeth
7680|Facial bones - complicated reduction with fixation and mul-
7710|Maxilla - open reduction
7720|Maxilla - closed reduction
7730|Mandible - open reduction
7740|Mandible - closed reduction
7750|Malar and/or zygomatic arch - open reduction
7760|Malar and/or zygomatic arch - closed reduction
7770|Alveolus - open reduction stabilization of teeth alveolus - open reducti
7771|Alveolus, closed reduction stabilization of teeth
7780|Facial bones - complicated reduction with fixation and multi-
7810|Open reduction of dislocation
7820|Closed reduction of dislocation
7830|Manipulation under anesthesia
7840|Condylectomy
7850|Surgical discectomy, with/without implant
7852|Disc repair
7854|Synovectomy
7856|Myotomy
7858|Joint reconstruction
7860|Arthrotomy
7865|Arthroplasty
7870|Arthrocentesis
7871|Non-arthroscopic lysis and lavage
7872|Arthroscopy, diagnosis,  with or without biopsy
7873|Arthroscopy-surgical:lavage and lysis of adhesions
7874|Arthroscopy -surgical:disc repositioning and stabilization
7875|Arthroscopy-surgical: synovectomy
7876|Arthroscopy-surgical:discectomy
7877|Arthroscopy- surgical:debridement
7880|Occlusal orthotic appliance
7881|Occlusal orthotic device adjustment
7899|Unspecified tmd therapy, by report
7910|Suture of recent small wounds up to 5 cm
7911|Complicated suture-up to5cm
7912|Complicated suture-greater than 5cm
7920|Skin graft (identify defect covered, location, and type of graft)
7921|Collection and application of autologous blood concentrate product
7922|PLCMT INTRA-SOC BIOL DRSG AID HEMO
7940|Osteoplasty - for orthognathic deformities
7941|Osteotomy - mandibular rami osteotomy - mandibular rami
7943|Osteotomy - mandibular rami with bone graft; includes obtaining the graf
7944|Osteotomy - segmented or subapical
7945|Osteotomy - body of mandible
7946|Lefort i (maxilla - total)
7947|Lefort i (maxilla - segmented)
7948|Lefort ii or lefort iii (osteoplasty of facial bones for midface
7949|Lefort ii or lefort iii - with bone graft
7950|Osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla - autogenous or nonautogenous, by report
7951|Sinus augmentation with bone or bone substitutes
7952|Sinus augumentation via a vertical approach
7953|Bone replacement graft for ridge preservation - per site
7955|Repair of maxillofacial soft and/or hard tissue defect
7960|Frenulectomy - also known as frenectomy or frenotomy - separate procedure not incidental to another procedure - Deleted 2021
7961|Buccal/labial frenectomy (frenulectomy)
7962|Lingual frenectomy (frenulectomy)
7963|Frenuloplasty
7970|Excision of hyperplastic tissue - per arch
7971|Excision of pericoronal gingiva
7972|Surgical reduction of fibrous tuberosity
7979|non-surgical sialolithotomy
7980|Sialolithotomy
7981|Excision of salivary gland, by report
7982|Sialodochoplasty
7983|Closure of salivary fistula
7990|Emergency tracheotomy
7991|Coronoidectomy
7992|Eminenectomy
7993|Surgical placement of craniofacial implant - extra oral
7994|Surgical placement: zygomatic implant
7995|Synthetic graft-mandible or facial bones, by report
7996|Implant-mandible for augmentation purposes (excluding alveolar ridge), b
7997|Appliance removal (not by dentist who placed appliance), includes remova
7998|Intraoral placement of a fixation device not in conjuction with a fractur
7999|Unspecified oral surgery procedure, by report
8010|Limited orthodontic treatment of the primary dentition
8020|Limited orthodontic treatment of the transitional dentition
8030|Limited orthodontic treatment of the adolescent dentition
8040|Limited orthodontic treatment of the adult dentition
8050|Interceptive orthodontic treatment of the primary dentition
8060|Interceptive orthodontic treatment of the transitional dentition
8062|Prefabricated esthetic coated stainless steel crown - primary tooth
8063|Interceptive Fixed - Clear
8070|Comprehensive orthodontic treatment of the transitional dentition
8071|Comprehensive orthodontic treatment of the transitional dentition (first six months)
8072|Comprehensive orthodontic treatment of the transitional dention (second six months)
8073|Comprehensive orthodontic treatment of the transitionaldentition (third six months)
8074|Comprehensive orthodontic treatment of the transitional dention (fourth six months)
8080|Comprehensive orthodontic treatment of the adolescent dentition
8081|Comprehensive orthodontic treatment of the adolescent dentition (first six months)
8082|Comprehensive orthodontic treatment of the adolescent dentition (second six months)
8083|Comprehensive orthodontic treatment of the adolescent dentition (third six months)
8084|Comprehensive orthodontic treatment of the adolescent dentition (fourth six months)
8090|Comprehensive orthodontic treatment of the adult dentition
8091|Comprehensive orthodontic treatment of the adult dentition (first six months)
8092|Comprehensive orthodontic treatment of the adult dentition (second six months)
8093|Comprehensive orthodontic treatment of the adult dentition (third six months)
8094|Comprehensive orthodontic treatment of the adult dentition (fourth six months)
8110|Orthodontic Rem Appliance Tx
8120|Fixed Appliance Therapy Guid
8210|Removable appliance therapy
8220|Fixed appliance therapy
8360|Orthodontic Rem Appliance Tx
8370|Fixed Appliance Interceptive
8460|Trans Dentit Class 1 Maloccl
8470|Class II Malocclusion Trnstn
8480|Class III Malocclusion Trnst
8560|Class I Tx Atyp/Ext Skel CAS
8570|Class II Malocclusion Perman
8580|Class III Malocclusion Permn
8650|Tx Atypical/Extend Skel Case
8660|Pre-orthodontic visit
8670|Periodic orthodontic treatment visit
8680|Orthodontic retention (removal of appliances, construction and placement
8681|Removable orthodontic retainer adjustment
8690|Orthodontic treatment (alternative billing to a contract fee)
8691|Repair of orthodontic appliance
8692|Replacement of lost or broken retainer
8693|Re-cement or re-bond fixed retainers
8694|Repair of fixed retainers, includes reattachment
8695|removal of fixed orthodontic appliances for reasons other than completion of treatment
8696|REPAIR ORTHODONTIC APPLIANCE - MAX
8697|REPAIR ORTHODONTIC APPLIANCE - MAND
8698|RE-CEMENT/RE-BOND FIX RETAIN - MAX
8699|RE-CEMENT/RE-BOND FIX RETAIN - MAND
8701|REPR FIX RETAIN INCL REATTACH - MAX
8702|REPR FIX RETAIN INCL REATTCH - MAND
8703|REPL LOST/BROKEN RETAINER - MAX
8704|REPL LOST/BROKEN RETAINER - MAND
8750|Post-Treatment Stabilization
8999|Unspecified orthodontic procedure, by report
9110|Palliative (emergency) treatment of dental pain - minor procedures
9120|Fixed partial denture sectioning
9130|temporomandibular joint dysfunction noninvasive physical therapies.
9210|Local anesthesia  not in conjunction with operative or surgical
9211|Regional block anesthesia
9212|Trigeminal division block anesthesia
9215|Local anesthesia in conjunction with operative or surgical procedures
9219|Evaluation for moderate sedation, deep sedation or general anesthesia
9220|General anesthesia-first 30 minutes
9221|General anesthesia-each additional 15 minutes
9222|deep sedation/general anesthesia  first 15 minutes
9223|Deep sedation/general anesthesia - each 15 minute increment
9230|Inhalation of nitrous oxide / anxiolysis, analgesia
9239|intravenous moderate (conscious) sedation/analgesia  first 15 minutes
9241|Intravenous conscious sedation/analgesia  first 30 minutes (parenteral sedation)
9242|Intravenous conscious sedation/analgesia  each additional 15 minutes (parenteral sedation)
9243|Intravenous moderate (conscious) sedation/analgesia - each 15  minute increment
9248|Non-intravenous (conscious) sedation
9310|Consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician
9410|House/extended care facility call house/extended care facility call
9420|Hospital or amublatory surgical center call
9430|Office visit for observation (during regularly scheduled hours)
9440|Office visit - after regularly scheduled hours
9450|Case presentation, detailed and extensive treatment planning
9610|Therapeutic parenteral drug, single administration
9612|Therapeutic parenteral drugs, two or more administrations, different medications
9613|infiltration of sustained release therapeutic drug G?? single or multiple sites.
9630|Other drugs and/or medicaments, by report
9910|Application of desensitizing medicaments
9911|Application of desensitizing resin for cervical and/or root surface, per
9920|Behavior management, by report
9930|Treatment of complications (postsurgical) - unusual
9931|Cleaning and inspection of a removable appliance
9932|Cleaning and inspection of removable complete denture, maxillary
9933|Cleaning and inspection of removable complete denture, mandibular
9934|Cleaning and inspection of removable partial denture, maxillary
9935|Cleaning and inspection of removable partial denture, mandibular
9940|Occlusal guards, by report (2019 Deletion)
9941|Fabrication of athletic mouthguards
9942|Repair and/or reline of occlusal guard
9943|Occlusal guard adjustment
9944|Occlusal guard - hard appliance, full arch (Replaces D9940 Occlusal guard)
9945|occlusal guard soft appliance, full arch.
9946|occlusal guard hard appliance, partial arch.
9950|Occlusion analysis - mounted case
9951|Occlusal adjustment - limited
9952|Occlusal adjustment - complete
9961|duplicate/copy patient records
9970|Enamel microabrasion
9971|Odontoplasty 1 - 2 teeth; includes removal of enamel projections
9972|External bleaching  - per arch
9973|External bleaching - per tooth
9974|Internal bleaching - per tooth
9975|External bleaching for home application, per arch; includes materials and fabrication of custom trays
9985|Sales tax
9986|Missed appointment
9987|Cancelled appointment
9990|certified translation or sign-language services per visit
9991|Case mgmt, appt barriers
9992|Case mgmt, care coordination
9993|Case mgmt, interviewing
9994|Case mgmt, pt education
9995|teledentistry  synchronous; real-time encounter
9996|teledentistry  asynchronous; information stored and forwarded to dentist for subsequent review
9997|DENTAL CASE MGMT-PTS SPCL HC NEEDS
9998|Unspecified miscellaneous service procedure
9999|Unspecified adjunctive procedure, by report
ADJ|Adjustment - Guardian
D0000|Principle Life Insurance - PPE benefit payment
D0001|Anthem - Prior Deduct Credit
D0002|Anthem - Current Year Benefit Paid to Date
D0003|Anthem - Prior Life Benefit Paid
D0004|Anthem - Ortho Current Year Benefit Year to
D0005|Anthem - Ortho Prior Life Benefit Year to Da
D0006|Anthem - LIFETIME DEDUCT CRDT
D0007|Anthem - TMJ Deductible Credit
D0008|Anthem - Vision Exam
D0009|Anthem - Specialty Maximum
D0010|Anthem - TMJ Lifetime Prior Credit
D0012|Anthem - Carry In
D0020|Anthem - Test Procedure Code
D0077|Anthem - CODE NOT ACCEPTED
D0088|Anthem - NO CODE SUBMITTED
D0110|Anthem - INITIAL ORAL EXAM
D0120|Periodic oral exam established patient
D0130|Anthem - EMERGENCY ORAL EXAM
D0140|Limited oral evaluation - problem focused
D0145|Oral evaluation for a patient under three years of age and counseling with primary caregiver
D0150|Comprehensive oral evaluation - new or established patient comprehensive
D0160|Detailed and extensive oral evaluation - problem focused, by report
D0170|Re-evaluation-limited, problem focused (established patient; not post-op
D0171|Re-evaluation post operative office visit
D0180|Comprehensive periodontal evaluation - new or established patient
D0190|Screening of a patient
D0191|Assessment of a patient
D0199|Anthem - OFFICE VISIT
D0210|Intraoral-complete series of radiographic images
D0220|Intraoral-periapical first radiographic image
D0230|Intraoral-periapical each additional radiographic image
D0240|Intraoral-occlusal radiographic image
D0250|Extra-oral - 2d projection radiographic image created using a stationary radiation source, and detector
D0251|Extra-oral posterior dental radiographic image
D0260|Extraoral-each additional film
D0270|Bitewing-single radiographic image
D0272|Bitewings-two radiographic images
D0273|Bitewings-three radiographic images
D0274|Bitewings-four radiographic images
D0275|Bitewings-each additional film
D0277|Vertical bitewings-7 to 8 radiographic images
D0280|Anthem - BITEWING-ADDITIONAL
D0290|Posterior-anterior or lateral skull and facial bone survey radiographic image
D0310|Saliography
D0320|Temporomandibular joint arthrogram, including injection
D0321|Other temporomandibular joint radiographic images by report
D0322|Tomographic survey
D0330|Panoramic radiographic image
D0340|2d celphalometric radiographic image - acquisition, measurement and analysis
D0350|2d oral/facial photographic image obtained intra-orally or extra- orally
D0351|3d photograhic image
D0360|Cone beam ct - craniofacial data capture
D0362|Cone beam - two-dimensional image reconstruction using existing data, includes multiple images
D0363|Cone beam - three-dimensional image reconstruction using existing data, includes multiple images
D0364|Cone beam ct capture and interpretation with limited field of view- less than one whole jaw
D0365|Cone beam ct capture and interpretation with field of view of one full dental arch-mandible
D0366|Cone beam ct capture and interpretation with field of view of one full dental arch-maxilla, with or without cranium
D0367|Cone beam ct capture and interpretation with field of view of both jaws with or without cranium
D0368|Cone beam ct capture and interpretation for tmj series including two or more exposures
D0369|Maxillofacial mri capture and interpretation
D0370|Maxilofacial ultrasound capture and interpretation
D0371|Sialoendoscopy capture and interpretation
D0380|Cone beam ct image capture with limited field of view-less than one whole jaw
D0381|Cone beam ct image capture with field of view of one full dental arch-mandible
D0382|Cone beam ct inmage capture with foeld of view of one full dental arch-maxilla, with or without cranium
D0383|Cone beam ct image capture with field of view of view of both jaws, with or wothout cramium
D0384|Cone beam ct image capture for tmj series including two or more exposures
D0385|Maxillofacial mri image capture
D0386|Maxillofacial ultrasound image capture
D0391|Interpretation of diagnostic image by a practitioner not associated with capture of the image, including report
D0393|Treatment simulation using 3d image valume
D0394|Digital subtraction of two or more images or image volumes of the same modality
D0395|Fusion of two or more 3d image volumes of one or more modalities
D0410|Anthem - BACTERIAL CULT EXAM
D0411|HbA1c in - office point of service testing
D0412|blood glucose level test in-office using a glucose meter.
D0414|Lab process microbial spec
D0415|Collection of microorganisms for culture and sensitivity
D0416|Viral culture
D0417|Collection & preparation of saliva sample for laboratory diagnostic test
D0418|Analysis of saliva sample
D0419|ASSESSMENT SALIVARY FLOW MEASUREMNT
D0420|Anthem - CARIES SUSCEP. TEST
D0421|Genetic test for susceptibility to oral diseases
D0422|Collection and preparation of genetic sample material for laboratory analysis and report
D0423|Genetic test for susceptibility to disease - specimen analysis
D0425|Caries susceptibility tests
D0431|Adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities
D0450|Anthem - HISTOPATHOLOGIC EXAM
D0460|Pulp vitality tests
D0470|Diagnostic casts
D0471|Anthem - DIAGNOSTIC PHOTOS
D0472|Accession of tissue, gross examination, preparation and transmission of
D0473|Accession of tissue, gross and microscopic examination, preparation and
D0474|Accession of tissue, gross and microscopic examination, including assess
D0475|Decalcification procedure
D0476|Special stains for microorganisms
D0477|Special stains, not for microorganisms
D0478|Immunohistochemical stains
D0479|Tissue in-situ hybridization, including interpretation
D0480|Accession of exfoliative cytologic smears, microscopic examination, preparation and transmission of written report
D0481|Electron microscopy-diagnostic
D0482|Direct immunofluorescence
D0483|Indirect immunofluorescence
D0484|Consultation on slides prepared elsewhere
D0485|Consultation, including preparation of slides from biopsy material supplied by referring source
D0486|Accession transepithelial cytologic sample, microscopic examination, preparation and trasnmission of written report
D0501|Anthem - HISTOPATHOLOGIC EXAM
D0502|Other oral pathology procedures, by report
D0600|Non-ionizing diag proc
D0601|Caries risk assessment and documentation, with a finding of low risk
D0602|Caries risk assessment and documentation, with a finding of moderate risk
D0603|Caries risk assessment and documentation, with a finding of high risk
D0604|Antigen testing for a public health related pathogen includes coronavirus
D0605|Antibody testing for a public health related pathogen includes coronavirus
D0701|Panoramic radiographic image - image capture only
D0702|2-D cephalometric radiographic image - image capture only
D0703|2-D oral/facial photographic image obtained intra-orally or extra-orally - image capture only
D0704|3-D photographic image - image capture only
D0705|Extra-oral posterior dental radiographic image - image capture only
D0706|Intraoral - occlusal radiographic image - image capture only
D0707|Intraoral - periapical radiographic image - image capture only
D0708|Intraoral - bitewing radiographic image - image capture only
D0709|Intraoral - complete series of radiographic images - image capture only
D0999|Unspecified diagnostic procedure, by report
D0PPE|ALLOWANCE FOR PPE - SunLife
D1110|Prophylaxis - adult
D1120|Prophylaxis - child
D1201|Topical Application of Fluoride (Including Prophylaxis)- Child
D1202|Anthem - FLUORIDE/PROPHY ADUL
D1203|Topical application of fluoride (prophylaxis not included)child (under 21 years of age)
D1204|Topical application of fluoride (prophylaxis not included)adult (21 years of age and older)
D1205|topical application of flouride (including prophylasix) -adult
D1206|Topical application of fluoride varnish
D1208|Topical application of fluoride
D1210|Anthem - FLRIDE SOD 4 NO PROP
D1220|Anthem - FLRIDE STA 1 NO PROP
D1221|Anthem - FLRIDE STA 1 PROPHY
D1230|Anthem - FLRIDE PHO 1 NO PROP
D1231|Anthem - FLRIDE PHO 1 PROPHY
D1310|Nutritional counseling for the control of dental disease
D1320|Tobacco counseling for the control and prevention of oral disease
D1321|Counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use
D1330|Oral hygiene instruction
D1350|Anthem - SEALANTS-PER QUAD
D1351|Sealant - per tooth
D1352|Preventative resin restoration in a moderat to high caries risk patient-permanent tooth
D1353|Sealant repair- per tooth
D1354|Intermin caries arresting medicament application
D1355|Caries preventive medicament application - per tooth
D1510|Space maintainer - fixed-unilateral
D1515|Space maintainer - fixed-bilateral (2019 deletion)
D1516|space maintainer fixed bilateral, maxillary
D1517|space maintainer fixed bilateral, mandibular
D1520|Space maintainer - removable- unilateral
D1525|Space maintainer - removable- bilateral (2019 deletion)
D1526|space maintainer removable bilateral, maxillary
D1527|space maintainer removable bilateral, mandibular
D1530|Anthem - SPACE MAINT-ACRY
D1550|Re-cement or re-bond space maintainer
D1551|RE-CEM/RE-BOND BIL SPACE MNTNR-MAX
D1552|RE-CEM/RE-BOND BIL SPC MNTNR - MAND
D1553|RE-CEM/RE-BOND UNI SPACE MNTNR-QUAD
D1555|Removal of fixed spacer maintainer
D1556|REMV FIX UNI SPACE MNTNR - PER QUAD
D1557|REMOVAL FIXED BIL SPACE MNTNR - MAX
D1558|REMOVAL FIX BIL SPACE MNTNR - MAND
D1575|Dist space maint, fixed unil
D1999|Unspecified preventive procedure, by report
D2110|Anthem - AMALGAM - ONE SURFACE, PRIMARY
D2120|Anthem - AMALGAM - TWO SURFACES, PRIMARY
D2130|Anthem - AMALGAM - THREE SURFACES, PRIMARY
D2131|Anthem - AMALGAM - FOUR+ SURFACES, PRIMARY
D2140|Amalgam-one surface, primary or permanent amalgam-one surface, primary o
D2150|Amalgam-two surfaces, primary or permanent amalgam-two surfaces, primary
D2160|Amalgam-three surfaces, primary or permanent amalgam-three surfaces, pri
D2161|Amalgam-four or more surfaces, primary or permanent amalgam- four or more
D2190|Anthem - PIN RETENTION/AMALG
D2210|Anthem - SILICATE CEMENT PER RESTORATION
D2222|Onlay-resin-based composite-four or more surfaces
D2310|Anthem - ACRYLIC/PLAST REST
D2311|Anthem - SYNTH REST-PIN RETND
D2330|Resin-one surface, anterior
D2331|Resin-two surfaces, anterior
D2332|Resin-three surfaces, anterior
D2334|Anthem - PIN RETENTION/COMPOS
D2335|Resin-four or more surfaces on involving incisal angle
D2336|Anthem - RESIN CROWN, ANTERIOR-PRIMARY
D2337|Anthem - RESIN CROWN, ANTERIOR-PERMANENT
D2338|Anthem - INVALID CDT-2 CODE
D2340|Anthem - INVALID CDT-2 CODE
D2380|Anthem - RESIN 1 SURFACE, POSTERIOR-PRIMARY
D2381|resin-two surfaces, posterior-primary
D2382|resin-three or more surfaces, posterior-primary
D2385|resin-one surface, posterior-permanent
D2386|Anthem - RESIN 2 SURFACES, POSTERIOR-PERM
D2387|Anthem - RESIN 4+ SURFACES, POSTERIOR-PERM
D2388|Anthem - RESIN COMP-4+ SURF
D2390|Resin-based composite crown, anterior
D2391|Resin-based composite - one surface, posterior
D2392|Resin-based composite - two surfaces, posterior
D2393|Resin-based composite - three surfaces, posterior
D2394|Resin-based composite - four or more surfaces, posterior
D2410|Gold foil - one surface
D2420|Gold foil - two surfaces
D2430|Gold foil - three surfaces
D2510|Inlay - metallic - one surface
D2520|Inlay - metallic -two surfaces
D2525|Anthem - INLY/ONLAY 2 SURFACE
D2530|Inlay - metallic - three  surfaces
D2535|Anthem - INLY/ONLAY 3 SURF
D2540|Anthem - INLAY/ONLAY METALLIC
D2542|Onlay-metallic-two surfaces
D2543|Onlay - metallic - three surfaces
D2544|Onlay - metallic - four or more surfaces
D2610|Inlay - porcelain/ceramic - one surface
D2620|Inlay - porcelain/ceramic-two surfaces
D2630|Inlay - porcelain/ceramic-three surfaces
D2640|Anthem - INLAY PORC/CERAMIC
D2642|Onlay - porcelain/ceramic - two surfaces
D2643|Onlay - porcelain/ceramic - three surfaces
D2644|Onlay - porcelain/ceramic - four or more surfaces
D2650|Inlay - resin-based composite - one surface inlay - resin-based composit
D2651|Inlay - resin-based composite - two surfaces inlay - resin-based composi
D2652|Inlay - resin-based composite - three or more surfaces inlay - resin-bas
D2660|Anthem - ONLAY/RESINPER TOOT
D2662|Onlay - resin-based composite - two surfaces onlay - resin-based composi
D2663|Onlay - resin-based composite - three surfaces onlay - resin- based compo
D2664|Onlay - - resin-based composite - four or more surfaces onlay - - resin-
D2710|Crown-resin-based composite (indirect)
D2711|Anthem - PLASTIC PREFAB CROWN
D2712|Crown - 3/4 resin-based composite (indirect)
D2720|Crown-resin with high noble metal
D2721|Crown-resin with predominantly base metal
D2722|Crown-resin with noble metal
D2740|Crown-porcelain/ceramic substrate
D2750|Crown-porcelain fused to high noble metal
D2751|Crown-procelain fused to predominantly base metal
D2752|Crown-porcelain fused to noble metal
D2753|CRWN - PORCLN FUSD TO TIT & TIT ALY
D2780|Crown - 3/4 cast high noble metal
D2781|Crown - 3/4 cast predominantly base metal
D2782|Crown - 3/4 cast noble metal
D2783|Crown - 3/4 porcelain/ceramic
D2790|Crown - full cast high noble metal
D2791|Crown - full cast predominantly base metal
D2792|Crown - full cast noble metal
D2794|Crown-titanium
D2799|Provisional crown-further treatment or completion of diagnosis necessary prior to final impression
D2810|Anthem - CROWN 3/4 CAST METALLIC
D2830|Anthem - STNLS STEEL CROWN-PR
D2840|Anthem - TEMP CROWN/FRACT TTH
D2890|Anthem - PIN RETENT/CROWN
D2891|Anthem - CAST POST W/CROWN
D2892|Anthem - PREFAB POST W/CROWN
D2910|Recement inlay, onlay or partial coverage restoration
D2915|Recement cast or prefabricated post and core
D2920|Recement crown
D2921|Reattachment of tooth fragment, incisal edge or cusp
D2928|Prefabricated porcelain/ceramic crown - permanent tooth
D2929|Prefabricated porcelain/ceramic crown-primary tooth
D2930|Prefabricated stainless steel crown - primary tooth
D2931|Prefabricated stainless steel crown - permanent tooth
D2932|Prefabricated resin crown
D2933|Prefabricated stainless steel crown with resin window
D2934|Prefabricated esthetic coated stainless steel crown - primary tooth
D2940|Protective restoration post removal
D2941|Interim therapeutic restoration- primary dentition
D2949|Restorative foundation for an indirect restoration
D2950|Core buildup, including any pins when required
D2951|Pin retention - per tooth, in addition to restoration
D2952|Post and core in addition to crown, indirectly fabricated
D2953|Each additional indirectly fabricated post - same tooth
D2954|Prefabricated post and core in addition to crown
D2955|Post removal (not in conjuction with endodontic therapy)
D2957|Each additional prefabricated post - same tooth
D2960|Labial veneer (laminate)-chairside
D2961|Labial veneer (resin laminate)- laboratory
D2962|Labial veneer (porcelain laminate)- laboratory
D2970|Temporary crown (fractured tooth)
D2971|Additional procedures to construct new crown under existing partial denture
D2975|Coping
D2980|Crown repair necessitated by restorative material failure
D2981|Inlay repair necessitaed by restorative material failure
D2982|Onlay repair necessitated by restorative material failure
D2983|Vaneer repair necessitated by restorative material failure
D2990|Resin infiltration of incipient smooth surface lesions
D2998|Anthem - UNSPEC MINOR REST
D2999|Unspecified restorative procedure, by report
D3110|Pulp cap - direct (excluding final restoration)
D3120|Pulp cap -indirect  (excluding final restoration)
D3130|Anthem - RECALCIF-SEDAT FILLG
D3220|Therapeutic pulpotomy (excluding final restoration)  removal of pulp cor
D3221|Pulpal debridement, primary and permanent teeth pulpal debridement, prim
D3222|Partial pulpotomy for apexogenesis - permanent tooth with incompleted root development
D3230|Pulpal therapy (resorbable filling)-anterior, primary tooth (excluding f
D3240|Pulpal therapy (resorbable filling)-posterior, primary tooth (excluding
D3310|Endodontic therapy, anterior tooth (excluding final restoration)
D3311|Anthem - 1 RT CANAL-SARGENTI
D3320|Endodontic therapy, bicuspid tooth (excluding final restoration)
D3321|Anthem - 2 RT CANAL-SARGENTI
D3330|Endodontic therapy, molar (excluding final restoration)
D3331|Treatment of root canal obstruction; non-surgical access
D3332|Incomplete endodontic therapy; inoperable, unrestorable or fractured tooth
D3333|Internal root repair of perforation defects
D3340|Anthem - 4 ROOT CANALS-MOLAR
D3341|Anthem - 4 RT CANAL-SARGENTI
D3346|Retreatment-anterior, by report
D3347|Retreatment-bicuspid, by report
D3348|Retreatment-molar, by report
D3350|Anthem - APEXIFICATION
D3351|Apexification/ recalcification- initial visit (apical closure/ calcific repair of perforations, root resorption, pulp space disinfection, etc.)
D3352|Apexification/recalcification- interim medication replacement
D3353|Apexification/recalcification-final visit (includes completed root canal
D3355|Pulpal regeneration- initial visit
D3356|Pulpal regeneration- interim medication replacement
D3357|Pulpal regeneration- completion of treatment
D3410|Apicoectomy- anterior
D3411|Anthem - APICOECTOMY-ADD'L RT
D3420|Anthem - APICOECTOMY/ENDO MAN
D3421|Apicoectomy- bicuspid (first root)
D3425|Apicoectomy- molar (first root)
D3426|Apicoectomy- each additional root
D3427|Periradicular surgery without apicoectomy - Deleted 2021
D3428|Bone graft in conjunction with periradicular surgery- per tooth, single site
D3429|Bone graft in conjunction with periradicular surgery- each additional contiguous tooth in the same surgical site
D3430|Retrograde filling - per root
D3431|Biological material to aid in soft and osseous tissue regeneration in conjunction with periradicular surgery
D3432|Guided tissue regeneration, resorbable barrier, per site, in conjuction with periradicular surgery
D3440|Anthem - APICAL CURETTAGE
D3450|Root amputation - per root
D3460|Endodontic endosseous implant
D3470|Intentional replantation (including necessary splinting)
D3471|Surgical repair of root resorption - anterior
D3472|Surgical repair of root resorption - premolar
D3473|Surgical repair of root resorption - molar
D3501|Surgical exposure of root surface without apicoectomy or repair of root resorption - anterior
D3502|Surgical exposure of root surface without apicoectomy or repair of root resorption - premolar
D3503|Surgical exposure of root surface without apicoectomy or repair of root resorption - molar
D3910|Surgical procedure for isolation of tooth with rubber dam
D3911|Intraorifice barrier (not to be used as a final restoration)
D3920|Hemisection (including any root removal), not including root canal thera
D3940|Anthem - RECALCIF OR REPAIR
D3950|Canal preparation and fitting of preformed dowel or post
D3960|Anthem - BLEACHING OF TEETH
D3999|Unspecified endodontic procedure, by report
D4210|Gingivectomy or gingivoplasty- four or more contiguous teeth or tooth bounded spaces per quadrant, performed to eliminate suprabony pockets
D4211|Gingivectomy or gingivoplasty one to three contiguous teeth or tooth bounded spaces per quadrant
D4212|Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth
D4230|Anatomical crown exposure - four or more contiguous teeth per quadrant
D4231|Anatomical crown exposure - ont to three teeth per quadrant
D4240|Gingival flap procedure including root planning - four or more continguous teeth or tooth bounded spaces per quadrant
D4241|Gingival flap procedure including root planning - one to three continguous teeth or tooth bounded spaces per quadrant
D4245|Apically positioned flap
D4249|Crown lengthening-hard and soft tissue, by report
D4250|Anthem - MUCOGINGIVAL SURGERY PER QUADRANT
D4260|Osseous surgery (including elevation of a full thickness flap and closure)- four or more contiguous teeth or tooth bounded space per quandrant
D4261|Osseous surgery (including elevation of a  full thickness flap and closure)- one to three contiguous teeth or tooth bounded spaces per quandrant
D4262|Anthem - OSSEOUS GRAFT-MULTI
D4263|Bone replacement graft - first site in quadrant
D4264|Bone replacement graft - each additional site in quadrant
D4265|Biologic materials to aid in soft and osseous tissue regeneration
D4266|Guided tissue regeneration- resorbable barrier, per site
D4267|Guided tissue regeneration-non- resorbable barrier, per site (includes membrane removal)
D4268|Surgical revision procedure, per tooth
D4270|Pedicle soft tissue graft procedure
D4271|Free soft tissue graft procedure (including donor site surgery)
D4272|Apically repositioning flap procedure
D4273|Autogenous connective tissue graft procedures (including donor and recipient surgical sites) first tooth, implant, or edentulous tooth position in graft
D4274|Distal or proximal wedge procedure (when not performed in conjuction wit
D4275|Non-autogenous connective tissue graft (including recipient site and donor material) first tooth, implant, or edentulous tooth position in graft
D4276|Combined connective tissue and double pedicle graft, per tooth
D4277|Free soft tissue graft procedure (including recipient and donor surgical sites) first tooth, implant, or edentulous tooth position in graft
D4278|Free soft tissue graft procedure (including recipient and donor surgical sites) each additional tooth, implant, or edentulous tooth position in graft
D4283|Autogenous connective tissue graft procedure (including donor and recipient surgical sites) - each additional contiguous tooth, implant or edentulous tooth position in same graft site
D4285|Non-autogenous connective tissue graft procedure (including recipient surgical site and donor material) - each additional contiguous tooth, implant or edentulous tooth postiiion in same graft site
D4320|Provisional splinting - intracoronal
D4321|Provisional splinting - extracoronal
D4330|Anthem - OCCLUSAL ADJ-LIMITED
D4331|Anthem - OCCLUSAL ADJ-COMPLET
D4340|Anthem - PERIO SCALE-FULL MTH
D4341|Periodontal scaling and root planing - four or more teeth per quadrant
D4342|Periodontal scaling and root planing - one to three teeth, per quadrant
D4345|Anthem - PERIO SCALE FM
D4346|Scaling gingiv inflammation
D4355|Full mouth debridement to enable comprehensive evaluation and diagnosis
D4360|Anthem - SPECIAL PERIO APPL
D4365|Anthem - ATHLETIC MOUTHGRD
D4381|Localized delivery of antimicrobial via a controlled release vehicle into diseased crevicular tissue per tooth
D4910|Periodontal maintenance periodontal maintenance
D4920|Unscheduled dressing change (by someone other than treating dentist)
D4921|Gingival irrigation- per quadrant
D4999|Unspecified periodontal procedure, by report
D5110|Complete upper
D5120|Complete lower
D5130|Immediate upper
D5140|Immediate lower
D5210|Anthem - DNTR UP/LO NO CLSPS
D5211|maxillary partial denture-resin base (including any conventional clasps, rests and t
D5212|mandibular partial denture-resin base (including any conventional clasps, rests and t
D5213|Upper partial-cast metal base with resin saddles (including any conventi
D5214|Lower partial-cast metal base with resin saddles (including any conventi
D5215|Anthem - UP PRTL HGH NOBLE
D5216|Anthem - LO PRTL HIGH NOBLE
D5217|Anthem - LO PRTL HGH NOBLE
D5218|Anthem - LO ACRY BASE 2 CLSPS
D5220|Anthem - UP/LO PRTL ACRY BASE
D5221|Immediate maxillary partial denture- resin base (including any conventional clasps, rests, and teeth)
D5222|Immediate mandibular partial denture- resin base (including any conventional clasps, rests, and teeth)
D5223|Immediate maxillary partial denture- cast metal framework with resin denture bases (including any conventional clasps, rests, and teeth)
D5224|Immediate mandibular partial denture- cast metal framework with resin denture bases (including any conventional clasps, rests, and teeth)
D5225|Maxillary partial denture - flexible base (including any clasps, rests and
D5226|Mandibular partial denture - flexible base (including any clasps, rests and
D5227|Immediate maxillary partial denture - flexible base (including any clasps, rests and teeth) Covered once in a seven year period.
D5228|Immediate mandibular partial denture - flexible base (including any clasps, rests and teeth)
D5230|Anthem - LO PRTL CAST BASE
D5231|Anthem - LO PRTL CAST BASE
D5240|Anthem - LO PRTL CAST BASE
D5241|Anthem - UP PRTL CAST BASE
D5261|Anthem - UP PRTL CAST BASE
D5280|Anthem - PRTL DNTR UNILAT GLD
D5281|Removable unilateral partial denture-one piece cast metal  (2019 Deletion)
D5282|removable unilateral partial denture one-piece cast metal (including clasps and teeth), maxillary
D5283|removable unilateral partial denture one-piece cast metal (including clasps and teeth), mandibular
D5284|REMV UNI PRTL D 1 PC FLEX BASE QUAD
D5286|REM UNI PRTL D - 1 PC RESIN - QUAD
D5310|Anthem - EA ADD'L CLSP & REST
D5320|Anthem - EACH ADD'L TOOTH
D5410|Adjust complete denture-upper
D5411|Adjust complete denture - lower
D5415|ADJUSTMENT TO PARTIAL DENTURE
D5421|Adjust partial denture - upper
D5422|Adjust partial denture - lower
D5510|Repair broken complete denture base
D5511|repair broken complete denture base, mandibular
D5512|repair broken complete denture base, maxillary
D5520|Replace missing or broken teeth - complete denture (each tooth)
D5610|Repair resin saddle or base
D5611|repair resin partial denture base, mandibular
D5612|repair resin partial denture base, maxillary
D5620|Repair cast framework
D5621|repair cast partial framework , mandibular
D5622|repair cast partial framework, maxillary
D5630|Repair or replace broken clasp - per tooth
D5640|Replace broken teeth - per tooth
D5650|Add tooth to existing partial denture
D5660|Add clasp to existing partial denture - per tooth
D5670|Replace all teeth and acrylic on cast metal framework (maxillary)
D5671|Replace all teeth and acrylic on cast metal framework (mandibular)
D5680|Anthem - REPAIR/REPLACE CLASP
D5690|Anthem - ADD CLASP TO PARTIAL
D5699|Anthem - UNSPEC RMVL DNTR REP
D5710|Rebase complete upper denture
D5711|Rebase complete lower denture
D5720|Rebase upper partial denture
D5721|Rebase lower partial denture
D5730|Reline upper complete denture (chairside)
D5731|Reline lower complete denture (chairside)
D5735|USIC SPECIFIC PROCEDURE RELINE UPPER OR LOWER DENTURE
D5740|Reline upper partial denture (chairside)
D5741|Reline lower partial denture (chairside)
D5750|Reline upper complete denture (laboratory)
D5751|Reline lower complete denture (laboratory)
D5755|USIC SPECIFIC PROCEDURE RELINE UPPER OR LOWER DENTURE
D5760|Reline upper partial denture (laboratory)
D5761|Reline lower partial denture (laboratory)
D5810|Interim complete denture (upper)
D5811|Interim complete denture (lower)
D5820|Interim partial denture (upper)
D5821|Interim partial denture (lower)
D5830|Anthem - OBTURATOR FOR SURGIC
D5850|Tissue conditioning, upper-per denture unit
D5851|Tissue conditioning, lower-per denture unit
D5860|Overdenture-complete, by report
D5861|Overdenture-partial, by report
D5862|Precision attachment, by report
D5863|Overdenture- complete maxillary
D5864|Overdenture- partial maxillary
D5865|Overdenture - complete mandibular
D5866|Overdunture- partial mandibular
D5867|Replacement of replaceable part of semi-precision or precision attachmen
D5875|Modification of removable prosthesis following implant surgery
D5876|add metal substructure to acrylic full denture (per arch)
D5899|Unspecified removable prosthodontic procedure, by report
D5911|Facial moulage (sectional)
D5912|Facial moulage (complete)
D5913|Nasal prosthesis
D5914|Auricular prosthesis
D5915|Orbital prothesis
D5916|Ocular prosthesis
D5917|Composite facial prosthesis
D5918|Replacement prosthesis
D5919|Facial prosthesis
D5920|Ocular implant
D5921|Orbital implant
D5922|Nasal septal prosthesis
D5923|Ocular prosthesis,interim
D5924|Cranial prosthesis
D5925|Facial augmentation implant prosthesis
D5926|Nasal prosthesis replacement
D5927|Auricular prosthesis, replacement
D5928|Orbital prosthesis, replacement
D5929|Facial prosthesis, replacement
D5931|Obturator prosthesis, surgical
D5932|Obturator prosthesis, definitive
D5933|Obturator prosthesis, modification
D5934|Mandibular resection prosthesis with guide flange
D5935|Mandibular resection prosthesis without guide flange
D5936|Obturator/prosthesis, interim
D5937|Trismus appliance (not for tmd treatment)
D5951|Feeding aid
D5952|Speech aid prosthesis, pediatric
D5953|Speech aid prosthesis,adult
D5954|Palatal augmentation prosthesis
D5955|Palatal lift prosthesis,definitive
D5956|Obturator
D5957|Speech bulb
D5958|Palatal lift prosthesis, interim
D5959|Palatal lift prosthesis,modification
D5960|Speech aid prosthesis, modification
D5982|Surgical stent
D5983|Radiation carrier
D5984|Radiation shield
D5985|Radiation cone locator
D5986|Fluoride gel carrier
D5987|Commissure splint
D5988|Surgical splint
D5991|Vesiculobullous disease medicament carrier
D5992|Adult maxillofacial prosthetic by report
D5993|Maintenance and cleaing of a maxillofacial prosthesis (extra  or intraoral) other than required adjustments, by report
D5994|Peridontal medicament carrier with peripheral seal- laboratory processed - Deleted 2021
D5995|Periodontal medicament carrier with peripheral seal - laboratory processed - maxillary
D5996|Periodontal medicament carrier with peripheral seal - laboratory processed mandibular
D5999|Unspecified maxillofacial prosthesis, by report
D6010|Surgical placement of implant body:  endosteal implant
D6011|Second stage implant surgery
D6012|Surgical placement of interim implant body for transitional prosthesis: endosteal implant
D6013|Surgical placement of mini inplant
D6020|Anthem - ENDOSTEAL IMP ABUT
D6030|Anthem - ENDOSSEOUS IMPLANT
D6040|Subperiosteal implant
D6050|Transasseous implant
D6051|Interim abutment includes placement and removal
D6052|Semi- precision attachment abutment - Deleted 2021
D6053|Implant/abutment supported removable denture for completely edentulous arch
D6054|Implant/abutment supported removable denture for partially edentulous arch
D6055|Connecting bar - implant supported or abutment supported
D6056|Prefabricated abutment-includes modification and placement
D6057|Custom fabricated abutment- includes placement
D6058|Abutment supported porcelain/ceramic crown
D6059|Abutment supported porcelain fused to metal crown (high noble metal)
D6060|Abutment supported porcelain fused to metal crown (predominantly base me
D6061|Abutment supported porcelain fused to metal crown (noble metal)
D6062|Abutment supported cast metal crown (high noble metal)
D6063|Abutment supported cast metal crown (predominantly base metal)
D6064|Abutment supported cast metal crown (noble metal)
D6065|Implant supported porcelain/ceramic crown
D6066|Implant supported porcelain fused to metal crown (titanium, titanium all
D6067|Implant supported metal crown (titanium, titanium alloy, high noble metal)
D6068|Abutment supported retainer for porcelain/ceramic fpd
D6069|Abutment supported retainer for porcelain fused to metal fpd (high noble
D6070|Abutment supported retainer for porcelain fused to metal fpd (predominan
D6071|Abutment supported retainer for porcelain fused to metal fpd (noble meta
D6072|Abutment supported retainer for cast  metal fpd (high noble metal)
D6073|Abutment supported retainer for cast  metal fpd (predominantly base meta
D6074|Abutment supported retainer for cast  metal fpd (noble metal)
D6075|Implant supported retainer for ceramic fpd
D6076|Implant supported retainer for porcelain fused to metal fpd (titanium, t
D6077|Implant supported retainer for cast metal fpd (titanium, titanium alloy
D6078|Implant/abutment supported fixed denture for completely edentulous arch
D6079|Implant/abutment supported fixed denture for partially edentulous arch
D6080|Implant maintenance procedure when prosthesis are removed and reinserted, including cleansing of prosthesis and abutments
D6081|Scale & debride, single imp
D6082|IMPL SUP CR-PRCLN FU PREDM BASE ALY
D6083|IMPLANT SUPP CRWN - PORCELN FU NBL
D6084|IMPLANT SUPPORTED CROWN - PORCELN F
D6085|Provisional implant crown
D6086|IMPLANT SUPP CRWN - PREDOM BASE ALY
D6087|IMPLANT SUPP CROWN - NOBLE ALLOYS
D6088|IMPLANT SUPP CROWN - TI & TI ALLOYS
D6090|Repair implantsupported prosthesis by report
D6091|Replacement of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis, per attachment
D6092|Recement implant/abutment supported crown
D6093|Recement implant/abutment supported fixed partial denture
D6094|Abutment supported crown - (titanium)
D6095|Repair implant abutment, by report
D6096|remove broken implant retaining screw
D6097|ABUT SUPP CR-PORCELN FU TI & TI ALY
D6098|IMPL SUP RTN-PRCLN FU PRDM BASE ALY
D6099|IMPL SUP RTN FPD-PORCELN FU NBL ALY
D6100|Implant removal, by report
D6101|Debridement of a periimplant defect and surface cleaning of exposed implant surfaces, including flap entry and closure
D6102|Debridement and osseous contouring of a periimplant defect: includes surface cleaning of exposed implant surfaces and flap entry and closure
D6103|Bone graft for repair of peri- implant defect - does not include flap entry and closure.
D6104|Bone graft at time of implant placement, biologic material to aid in occeous regeneration are reported seperately
D6110|Implant/ abutment supported removable denture for edentulous arch- maxillary
D6111|Implant/ abutment supported removable denture for edentulous arch- mandibular
D6112|Implant/ abutment supported removable denture for partially endentulous arch- maxillary
D6113|Implant/ abutment supported removable denture for partially edentulous arch- mandibular
D6114|Implant/ abutment supported fixed denture for edentulous arch- maxillary
D6115|Implant/ abutment supported fixed denture for edentulous arch- mandibular
D6116|Implant/ abutment supported fixed denture for partially edentulous arch- maxillary
D6117|Implant/ abutment supported fixed denture for partially edentulous arch-mandibular
D6118|implant/abutment supported interim fixed denture for edentulous arch- mandibular
D6119|implant/abutment supported interim fixed denture for edentulous arch- maxillary
D6120|IMPL SUP RET PRCLN FU TIT & TIT ALY
D6121|IMPL SUP RET MTL FPD PREDM BASE ALY
D6122|IMPL SUP RET METAL FPD - NOBLE AL
D6123|IMPL SUP RET MTL FPD TIT & TIT ALY
D6190|Radiographic/surgical implant index, by report
D6191|Semi-precision abutment - placement
D6192|Semi-precision attachment - placement
D6194|Abutment supported retainer corwn for fpd - (titanium)
D6195|ABUT SUP RET-PRCLN FU TIT & TIT ALY
D6199|Unspecified implant procedure, by report
D6205|Pontic - indirect resin based composite
D6210|Pontic - cast high noble metal
D6211|Pontic - cast predominantly base metal
D6212|Pontic - cast noble metal
D6214|Pontic titanium
D6220|Anthem - PONT SLOTTED FACING
D6240|Pontic - porcelain fused to high noble metal
D6241|Pontic - porcelain fused to predominantly base metal
D6242|Pontic - porcelain fused to noble metal
D6243|PONTIC - PORCELN FU TIT & TIT ALY
D6245|Pontic - porcelain/ceramic
D6250|Pontic-resin with high noble metal
D6251|Pontic - resin with predominantly base metal
D6252|Pontic - resin with noble metal
D6253|Provisional pontic-futher treatment or completion of diagnosis necessary prior to final impression
D6519|Anthem - INLAY/ONLAY - PORCELAIN/CERAMIC
D6520|Anthem - INLAY - METALLIC - TWO SURFACES
D6530|Anthem - INLAY - METALLIC - THREE+ SURFACES
D6543|Anthem - ONLAY - METALLIC - THREE SURFACES
D6544|Anthem - ONLAY - METALLIC - FOUR+ SURFACES
D6545|Retainer-cast metal for acid etched fixed prosthesis
D6548|Retainer - porcelain/ceramic for resin bonded fixed prosthesis
D6549|Resin retainer for resin bonded fixed prosthesis
D6600|Retainer inlay - porcelain/ceramic, two surfaces
D6601|Retainer inlay - porcelain/ceramic, three or more surfaces
D6602|Retainer inlay - cast high noble metal, two surfaces
D6603|Retainer inlay - cast high noble metal, three or more surfaces
D6604|Retainer inlay - cast predominantly base metal , two surfaces
D6605|Retainer inlay - cast predominantly base metal , three or more surfaces
D6606|Retainer inlay - cast noble metal, two surfaces
D6607|Retainer inlay - case noble metal, three or more surfaces
D6608|Retainer onlay - porcelain/ceramic, two surfaces
D6609|Retainer onlay - porcelain/ceramic, three or more surfaces
D6610|Retainer onlay - cast high noble metal, two surfaces
D6611|Retainer onlay - cast high noble metal, three or more surfaces
D6612|Retainer onlay - cast predominantly base metal , two surfaces
D6613|Retainer onlay - cast predominantly base metal , three or more surfaces
D6614|Retainer onlay - cast noble metal, two surfaces
D6615|Retainer onlay - case noble metal, three or more surfaces
D6624|Retainer inlay - titanium
D6630|Anthem - RPLC BRKN PIN FACING
D6634|Retainer onlay - titanium
D6640|Anthem - REPLACE BRKN FACING
D6666|Anthem - INELIGIBLE PROCEDURE
D6710|Retainer crown - indirect resin based composite
D6720|Retainer crown - resin with high noble metal
D6721|Retainer crown - resin with predominantly base metal
D6722|Retainer crown - resin with noble metal
D6740|Retainer crown - porcelain/ceramic
D6750|Retainer crown - porcelain fused to high noble metal
D6751|Retainer crown - porcelain fused to predominantly base metal
D6752|Retainer crown - porcelain fused to noble metal
D6753|RET CRWN - PORCELN FU TIT & TIT ALY
D6760|Anthem - RVRS PIN FACING/METL
D6780|Retainer crown - 3/4 cast high noble metal
D6781|Retainer crown - 3/4 cast predominantly base metal
D6782|Retainer crown - 3/4 cast noble metal
D6783|Retainer crown - 3/4 porcelain/ceramic
D6784|RETAINER CROWN 3/4 - TI & TI ALLOYS
D6790|Retainer crown - full cast high noble metal
D6791|Retainer crown - full cast predominantly base metal
D6792|Retainer crown - full cast noble metal
D6793|Provisional retainer crown- further treatment or completion of diagnosis necessary prior to final impression
D6794|Retainer crown - titanium
D6795|interim retainer crown
D6920|Connector bar
D6930|Recement bridge
D6940|Stress breaker
D6950|Precision attachment
D6970|Post and core in addition to fix partial denture retainer, indirectly fabricated
D6971|Cast post as part of fixed partial denture retainer
D6972|Prefabricated post and core in addition to fixed partial denture retainer
D6973|Core buildup for retainer, including any pins
D6975|Coping-metal
D6976|Each additional indirectly fabricated post - same tooth
D6977|Each additional prefabricated post - same tooth
D6980|Fixed partial denture repair, necessitated by restorative material failure
D6985|Pediatric partial denture, fixed
D6999|Unspecified fixed prosthodontic procedure, by report
D7110|Extraction Single Tooth (deleted)
D7111|Extraction, coronal remnants - deciduous tooth
D7120|Extraction Each Additional Tooth(deleted)
D7130|Extraction Tooth Removal(deleted)
D7140|Extraction, erupted tooth or exposed root (elevation and/or forceps remo
D7210|Surgical removal of erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated
D7220|Removal of impacted tooth - soft tissue
D7230|Removal of impacted tooth - partially bony
D7240|Removal of impacted tooth - completely bony
D7241|Rem.imp. tooth, completely bony, with unusual surg. complications
D7250|Surgical removal of residual tooth roots (cutting procedure)
D7251|Coronectomy - intentional partial tooth removal
D7260|Oral antral fistula closure
D7261|Primary closure of a sinus perforation
D7270|Tooth reimplantation and/or stabilization of accidentally evulsed or dis
D7271|Anthem - TOOTH REIMPLANTATION
D7272|Tooth transplantation
D7280|Surgical access of an unerupted tooth surgical access of an unerupted to
D7281|Anthem - SURG EXPOS-IM UNERUP
D7282|Mobilization of erupted or malpositioned tooth to aid eruption
D7283|Placement of device to facilitate eruption of impacted tooth
D7285|Incisional biopsy of oral tissue- hard (bone, tooth)
D7286|Incisional biopsy of oral tissue - soft
D7287|Exfoliative cytological sample collection
D7288|Brush biopsy - transepithelial sample collection
D7290|Surgical repositioning of teeth
D7291|Transseptal fiberotomy/supra crestal fiberotomy, by report transseptal f
D7292|Surgical placement: temporary anchorage device (screw retained plate) requiring surgical flap
D7293|Surgical placement: temporary anchorage device requiring surgical flap
D7294|Surgical placement: temporary anchorage device without surgical flap
D7295|Harvest of bone for use in autogenous grafting procedure
D7296|corticotomy - one to three teeth or tooth spaces, per quadrant
D7297|corticotomy - four or more teeth or tooth spaces, per quadrant
D7310|Alveoloplasty in conjuction with extractions - four or more teeth or tooth spaces per quadrant
D7311|Alveoloplasy in conjunction with extractions - one to three teeth or tooth
D7320|Alveoloplasty not in conjuction with extractions - four or more teeth or tooth spaces per quadrant
D7321|Alveoloplasy not in conjunction with extractions - one to three teeth or tooth
D7340|Vestibuloplasty - ridge extension (second epithelialization)
D7350|Vestibuloplasty - ridge extension (including soft tissue grafts
D7410|Excision of benign lesion up to 1.25 cm excision of benign lesion up to
D7411|Excision of benign lesion greater than 1.25 cm
D7412|Excision of benign lesion, complicated
D7413|Excision of malignant lesion up to 1.25 cm
D7414|Excision of malignant lesion greater than 1.25 cm
D7415|Excision of malignant lesion, complicated
D7420|Anthem - EXCISION LESION DIAMETER > 1.25 CM
D7425|Anthem - EXC PERICOR GINGIVA
D7430|Cystectomy (<1.25cm):  Removal of  a small cyst
D7431|Cystectomy (>1.25cm):  Removal of a large cyst
D7440|Excision of malignant tumor - lesion diameter up to 1.25 cm
D7441|Excision of malignant tumor - lesion diameter over 1.25 cm
D7450|Removal of benign odontogenic cyst or tumor-lesion diameter up t0 1.25 c
D7451|Removal of benign odontogenic cyst or tumor-lesion diameter greater than
D7460|Removal of benign nonodontogenic cyst or tumor- lesion diameter up to 1.2
D7461|Removal of benign nonodontogenic cyst or tumor- lesion diameter greater t
D7465|Destruction of lesion(s) by physical methods: electrosurgery
D7470|Anthem - REMOVAL EXOSTOSIS MAXILLA/MANDIBLE
D7471|Removal of lateral exostosis (maxilla or mandible) removal of lateral ex
D7472|Removal of torus palatinus
D7473|Removal of torus mandibularis
D7480|Anthem - PARTIAL OSTECTOMY
D7485|Surgical reduction of osseous tuberosity
D7490|Radical resection of maxilla or mandible
D7510|Incision and drainage of abscess - intraoral soft tissue
D7511|Incision and drainage of abscess - intraoral soft tissue - complicated
D7520|Incision and drainage of abscess - extraoral soft tissue
D7521|Incision and drainage of abscess - extraoral soft tissue - complicated
D7530|Removal of foreign body from mucosa, skin, or subcutaneous alveolar tiss
D7540|Removal of reaction-producing foreign bodies - musculoskeletal
D7550|Partial ostectomy/sequestrectomy for removal of non-vital bone partial o
D7560|Maxillary sinusotomy for removal of tooth fragment or foreign
D7610|Maxilla - open reduction (teeth immobilized if present)
D7620|Maxilla - closed reduction (teeth immobilized if present)
D7630|Mandible - open reduction (teeth immobilized if present)
D7640|Mandible - closed reduction (teeth immobilized if present)
D7650|Malar and/or zygomatic arch - open reduction
D7660|Malar and/or zygomatic arch - closed reduction
D7670|Alveolus - closed reduction, may include stabilization of teeth alveolus
D7671|Alveolus - open reduction, may include stabilization of teeth
D7680|Facial bones - complicated reduction with fixation and mul-
D7710|Maxilla - open reduction
D7720|Maxilla - closed reduction
D7730|Mandible - open reduction
D7740|Mandible - closed reduction
D7750|Malar and/or zygomatic arch - open reduction
D7760|Malar and/or zygomatic arch - closed reduction
D7770|Alveolus - open reduction stabilization of teeth alveolus - open reducti
D7771|Alveolus, closed reduction stabilization of teeth
D7780|Facial bones - complicated reduction with fixation and multi-
D7810|Open reduction of dislocation
D7820|Closed reduction of dislocation
D7830|Manipulation under anesthesia
D7840|Condylectomy
D7850|Surgical discectomy, with/without implant
D7852|Disc repair
D7854|Synovectomy
D7856|Myotomy
D7858|Joint reconstruction
D7860|Arthrotomy
D7865|Arthroplasty
D7870|Arthrocentesis
D7871|Non-arthroscopic lysis and lavage
D7872|Arthroscopy, diagnosis,  with or without biopsy
D7873|Arthroscopy-surgical:lavage and lysis of adhesions
D7874|Arthroscopy -surgical:disc repositioning and stabilization
D7875|Arthroscopy-surgical: synovectomy
D7876|Arthroscopy-surgical:discectomy
D7877|Arthroscopy- surgical:debridement
D7880|Occlusal orthotic appliance
D7881|Occlusal orthotic device adjustment
D7899|Unspecified tmd therapy, by report
D7910|Suture of recent small wounds up to 5 cm
D7911|Complicated suture-up to5cm
D7912|Complicated suture-greater than 5cm
D7920|Skin graft (identify defect covered, location, and type of graft)
D7921|Collection and application of autologous blood concentrate product
D7922|PLCMT INTRA-SOC BIOL DRSG AID HEMO
D7940|Osteoplasty - for orthognathic deformities
D7941|Osteotomy - mandibular rami osteotomy - mandibular rami
D7942|Anthem - OSTEOTOMY RAMUS OPEN
D7943|Osteotomy - mandibular rami with bone graft; includes obtaining the graf
D7944|Osteotomy - segmented or subapical
D7945|Osteotomy - body of mandible
D7946|Lefort i (maxilla - total)
D7947|Lefort i (maxilla - segmented)
D7948|Lefort ii or lefort iii (osteoplasty of facial bones for midface
D7949|Lefort ii or lefort iii - with bone graft
D7950|Osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla - autogenous or nonautogenous, by report
D7951|Sinus augmentation with bone or bone substitutes
D7952|Sinus augumentation via a vertical approach
D7953|Bone replacement graft for ridge preservation - per site
D7955|Repair of maxillofacial soft and/or hard tissue defect
D7960|Frenulectomy - also known as frenectomy or frenotomy - separate procedure not incidental to another procedure - Deleted 2021
D7961|Buccal/labial frenectomy (frenulectomy)
D7962|Lingual frenectomy (frenulectomy)
D7963|Frenuloplasty
D7970|Excision of hyperplastic tissue - per arch
D7971|Excision of pericoronal gingiva
D7972|Surgical reduction of fibrous tuberosity
D7979|non-surgical sialolithotomy
D7980|Sialolithotomy
D7981|Excision of salivary gland, by report
D7982|Sialodochoplasty
D7983|Closure of salivary fistula
D7990|Emergency tracheotomy
D7991|Coronoidectomy
D7992|Eminenectomy
D7993|Surgical placement of craniofacial implant - extra oral
D7994|Surgical placement: zygomatic implant
D7995|Synthetic graft-mandible or facial bones, by report
D7996|Implant-mandible for augmentation purposes (excluding alveolar ridge), b
D7997|Appliance removal (not by dentist who placed appliance), includes remova
D7998|Intraoral placement of a fixation device not in conjuction with a fractur
D7999|Unspecified oral surgery procedure, by report
D8000|Anthem - ORTHO ACCUMULATOR
D8010|Limited orthodontic treatment of the primary dentition
D8020|Limited orthodontic treatment of the transitional dentition
D8030|Limited orthodontic treatment of the adolescent dentition
D8040|Limited orthodontic treatment of the adult dentition
D8050|Interceptive orthodontic treatment of the primary dentition
D8060|Interceptive orthodontic treatment of the transitional dentition
D8062|Prefabricated esthetic coated stainless steel crown - primary tooth
D8063|Interceptive Fixed - Clear
D8070|Comprehensive orthodontic treatment of the transitional dentition
D8071|Comprehensive orthodontic treatment of the transitional dentition (first six months)
D8072|Comprehensive orthodontic treatment of the transitional dention (second six months)
D8073|Comprehensive orthodontic treatment of the transitionaldentition (third six months)
D8074|Comprehensive orthodontic treatment of the transitional dention (fourth six months)
D8080|Comprehensive orthodontic treatment of the adolescent dentition
D8081|Comprehensive orthodontic treatment of the adolescent dentition (first six months)
D8082|Comprehensive orthodontic treatment of the adolescent dentition (second six months)
D8083|Comprehensive orthodontic treatment of the adolescent dentition (third six months)
D8084|Comprehensive orthodontic treatment of the adolescent dentition (fourth six months)
D8090|Comprehensive orthodontic treatment of the adult dentition
D8091|Comprehensive orthodontic treatment of the adult dentition (first six months)
D8092|Comprehensive orthodontic treatment of the adult dentition (second six months)
D8093|Comprehensive orthodontic treatment of the adult dentition (third six months)
D8094|Comprehensive orthodontic treatment of the adult dentition (fourth six months)
D8110|Orthodontic Rem Appliance Tx
D8120|Fixed Appliance Therapy Guid
D8160|Anthem - ORTHO CLASS 1
D8210|Removable appliance therapy
D8220|Fixed appliance therapy
D8360|Orthodontic Rem Appliance Tx
D8370|Fixed Appliance Interceptive
D8460|Trans Dentit Class 1 Maloccl
D8470|Class II Malocclusion Trnstn
D8480|Class III Malocclusion Trnst
D8560|Class I Tx Atyp/Ext Skel CAS
D8570|Class II Malocclusion Perman
D8580|Class III Malocclusion Permn
D8650|Tx Atypical/Extend Skel Case
D8660|Pre-orthodontic visit
D8665|Anthem specific Code for Orthodontia Records payment
D8670|Periodic orthodontic treatment visit
D8680|Orthodontic retention (removal of appliances, construction and placement
D8681|Removable orthodontic retainer adjustment
D8690|Orthodontic treatment (alternative billing to a contract fee)
D8691|Repair of orthodontic appliance
D8692|Replacement of lost or broken retainer
D8693|Re-cement or re-bond fixed retainers
D8694|Repair of fixed retainers, includes reattachment
D8695|removal of fixed orthodontic appliances for reasons other than completion of treatment
D8696|REPAIR ORTHODONTIC APPLIANCE - MAX
D8697|REPAIR ORTHODONTIC APPLIANCE - MAND
D8698|RE-CEMENT/RE-BOND FIX RETAIN - MAX
D8699|RE-CEMENT/RE-BOND FIX RETAIN - MAND
D8701|REPR FIX RETAIN INCL REATTACH - MAX
D8702|REPR FIX RETAIN INCL REATTCH - MAND
D8703|REPL LOST/BROKEN RETAINER - MAX
D8704|REPL LOST/BROKEN RETAINER - MAND
D8750|Post-Treatment Stabilization
D8880|Anthem - SINGLE PAYMENT
D8881|Anthem - APPLIANCE PLACEMENT
D8882|Anthem - SIX MONTH ORTHO PYMT
D8883|Anthem - 12 MO ORTHO PYMT
D8884|Anthem - ORTHO MONTHLY PYMT
D8885|Anthem - ORTHO QUARTERLY PYMT
D8886|Anthem - ORTHO SEMI-ANNUAL PM
D8887|Anthem - ORTHO DEBANDING PYMT
D8888|Anthem - MISC SPECIAL ADJSTMT
D8889|Anthem specific Code scheduled orthodontia payment
D8890|Anthem - DR ADJ PER CONTRACT
D8891|Anthem - ORTHO PROCESS CODE
D8892|Anthem - 18 MONTH ORTHO PAYMENT
D8899|Anthem - MISC ORTHO
D8990|Anthem - RETENTION VISIT
D8999|Unspecified orthodontic procedure, by report
D9030|Anthem - Establish orthodontia history
D9110|Palliative (emergency) treatment of dental pain - minor procedures
D9120|Fixed partial denture sectioning
D9130|temporomandibular joint dysfunction noninvasive physical therapies.
D9142|Anthem - Claim contains an interest amount
D9150|Anthem - IMP EXT SUPERNUMERAR
D9210|Local anesthesia  not in conjunction with operative or surgical
D9211|Regional block anesthesia
D9212|Trigeminal division block anesthesia
D9215|Local anesthesia in conjunction with operative or surgical procedures
D9219|Evaluation for moderate sedation, deep sedation or general anesthesia
D9220|General anesthesia-first 30 minutes
D9221|General anesthesia-each additional 15 minutes
D9222|deep sedation/general anesthesia  first 15 minutes
D9223|Deep sedation/general anesthesia - each 15 minute increment
D9225|Anthem - GEN ANESTH/HOSPITAL
D9230|Inhalation of nitrous oxide/anxiolysis, analgesia
D9239|intravenous moderate (conscious) sedation/analgesia  first 15 minutes
D9240|Anthem - INTRAVENOUS SEDATION
D9241|Intravenous conscious sedation/analgesia  first 30 minutes (parenteral sedation)
D9242|Intravenous conscious sedation/analgesia  each additional 15 minutes (parenteral sedation)
D9243|Intravenous moderate (conscious) sedation/analgesia - each 15 minute increment
D9248|Non-intravenous (conscious) sedation
D9310|Consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician
D9311|Consult w/med hlth care prof
D9410|House/extended care facility call house/extended care facility call
D9420|Hospital or amublatory surgical center call
D9430|Office visit for observation (during regularly scheduled hours)
D9440|Office visit - after regularly scheduled hours
D9450|Case presentation, detailed and extensive treatment planning
D9610|Therapeutic parenteral drug, single administration
D9612|Therapeutic parenteral drugs, two or more administrations, different medications
D9613|infiltration of sustained release therapeutic drug G?? single or multiple sites.
D9630|Other drugs and/or medicaments, by report
D9901|Anthem - IPA Compensation
D9902|Anthem - PPO Plan Reimbursement
D9905|Anthem - Grievance Resolution
D9906|Anthem - DOI Adjustment
D9907|Anthem - Guaranteed Eligibility
D9910|Application of desensitizing medicaments
D9911|Application of desensitizing resin for cervical and/or root surface, per
D9912|Capture and documentation of a patient's health status prior to or on the scheduled date of service to evaluate risk of infectious disease transmission if the patient is to be treated within the dental practice.
D9915|Anthem - SPEC COMP/ORTHO PMT
D9920|Behavior management, by report
D9930|Treatment of complications (postsurgical) - unusual
D9931|Cleaning and inspection of a removable appliance
D9932|Cleaning and inspection of removable complete denture, maxillary
D9933|Cleaning and inspection of removable complete denture, mandibular
D9934|Cleaning and inspection of removable partial denture, maxillary
D9935|Cleaning and inspection of removable partial denture, mandibular
D9940|Occlusal guards, by report (2019 Deletion)
D9941|Fabrication of athletic mouthguards
D9942|Repair and/or reline of occlusal guard
D9943|Occlusal guard adjustment
D9944|Occlusal guard - hard appliance, full arch (Replaces D9940 Occlusal guard)
D9945|occlusal guard soft appliance, full arch.
D9946|occlusal guard hard appliance, partial arch.
D9950|Occlusion analysis - mounted case
D9951|Occlusal adjustment - limited
D9952|Occlusal adjustment - complete
D9960|Anthem - COMPLETION OF FORMS
D9961|duplicate/copy patient records
D9970|Enamel microabrasion
D9971|Odontoplasty 1 - 2 teeth; includes removal of enamel projections
D9972|External bleaching  - per arch
D9973|External bleaching - per tooth
D9974|Internal bleaching - per tooth
D9975|External bleaching for home application, per arch; includes materials and fabrication of custom trays
D9985|Sales tax
D9986|Missed appointment
D9987|Cancelled appointment
D9990|certified translation or sign-language services per visit
D9991|Case mgmt, appt barriers
D9992|Case mgmt, care coordination
D9993|Case mgmt, interviewing
D9994|Case mgmt, pt education
D9995|teledentistry  synchronous; real-time encounter
D9996|teledentistry  asynchronous; information stored and forwarded to dentist for subsequent review
D9997|DENTAL CASE MGMT-PTS SPCL HC NEEDS
D9998|Anthem - Another primary carrier on  claim
D9999|Anthem - Uns Adjunctive Procedure
DNT|HealthSmart - Custom Dental UNKNOWN Code
DRUGP|Anthem - UNKNOWN_Brand or Generic
DUPX|Duplicate - Guardian
INT|Interest - Guardian
INTRS|STATE TAX
LTR|Letter - Guardian
M1110|Medical Prophylaxis - Guardian
MNTAX|Minnesota Tax - Guardian
N9999|Generic code used when no other code fits description - Guardian
ORTHO|Orthodontic services - Guardian
RX|Prescription - Guardian
TMJWK|TMJ Workup - Guardian
Z0200|Medicare-EPSDT EXAMINATION ALLOWABLE AT INITIAL V
Z0202|Medicare-ALL BITEWINGS
Z0245|Medicare-TRTMT OF VINCENT DISEASE LTHREE TREATMEN
Z0253|Medicare-OP GROUP III
Z1641|Medicare-EPSDT INTERPERIODIC DENTAL SCREEN
Z2473|Medicare-PREVENTIVE DENTAL SCREENING
