Most common D8400 code reviews : Pulpal Debridement, Primary or Permanent Tooth - Paid to the general dentist that will not be completing the endodontic treatment, Laboratory processing of microbial specimen to include culture and sensitivity studies, preparation and ransmission or written report or Resin-based composite - four or more surfaces or involving the incisal angle (anterior).
Prophylaxis-adult. For payment purposes, the distinction between the adult and child dentition is determined by contract. Any fee in excess is Disallowed and not chargeable to the Patient. In the absence of group contract language regarding age, a person age fourteen (14) and older is considered an adult for benefit determination purposes of a prophylaxis-adult.
Procedure in D8400 which the nearly exposed pulp is covered with a protective dressing to protect the pulp from dditional injury and to promote healing and repair via formation of secondary dentin This code is not to be used for bases and iners when all caries has been removed.
Scaling and debridement in the presence of inflammation or mucositis of a single implant, including cleaning of the implant surfaces, without flap entry and closure. (When submitted with prophy, considered inclusive of prophy; no separate benefit for 6081 or when submitted alone or in multiples, allow to pay as prophy, but subject to prophy limitation.)
Prefabricated post and core in addition to crown is payable only on a completed endodontically treated tooth. If sufficient tooth structure remains, the fee for the post and core is Disallowed. **A prefabricated post and core for an anterior tooth is Benefited only when there is insufficient tooth structure to support an indirectly fabricated restoration. If sufficient tooth structure remains, the fee for the post and core is Disallowed.
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