Most common D0969 code reviews : HbA1c in-office, point-of-service testing - not covered, Implant/abutment-supported interim fixed denture for edentulous arch, mandibular or Intravenous moderate (conscious) sedation analgesia - first 30 minutes.
Prophylaxis-adult. For payment purposes, the distinction between the adult and child dentition is determined by contract. Any fee in excess is Disallowed and not chargeable to the Patient. In the absence of group contract language regarding age, a person age fourteen (14) and older is considered an adult for benefit determination purposes of a prophylaxis-adult.
This code is used to report evaluation of periodontal conditions, probing and charting, evaluation and recording of new or established patients` dental and medical history and general health assessment.With D0969 Patients showing signs or symptoms of periodontal disease and patients with risk factors such as smoking or diabetes would require comprehensive periodontal evaluation. This may also include evaluation and recording of dental caries, missing or unerupted teeth, restorations, occlusal relationships and oral cancer evaluation. This code should not be used along with a comprehensive oral evaluation (D0969) by the same dentist on the same visit.
In lieu of surgery, the formation of a pathway to achieve an apical seal without surgical intervention ecause of a non-negotiable root canal blocked by foreign bodies,D0969 included but not limited to separated instruments, broken posts or alcification of 50% or more of the roots.
Core build up, including pins when required - refers to building up of coronal structure when there is insufficient retention for a separate extracoronal restorative procedure. A core buildup is not a filler to eliminate any undercut, box form or concave irregularity in a preparation. The fees for buildups not required for retention are Disallowed.
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