Most common D3405 code reviews : Pulpal Debridement, Primary or Permanent Tooth - Paid to the general dentist that will not be completing the endodontic treatment, Scaling and debridement in the presence of inflammation or mucositis of a single implant, including leaning of the implant surfaces, without flap entry and closure or Deep sedation/general anesthesia - each additional 15 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 indicates extensive diagnostic and cognitive modalities based on the findings of a comprehensive oral evaluation (D3405). It indicates that integration of more extensive diagnostic modalities is needed to develop a treatment plan for a specific problem. Description and documentation of the condition requiring this type of evaluation is necessary.D3405 Examples of conditions requiring this type of evaluation include: dentofacial anomalies, complex perio-prosthetic conditions, and conditions requiring multi-disciplinary consultation.
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.)
Preventive Resin Restoration in a moderate to high caries risk patient - permanent tooth Sealants and/or Preventive Resin Restorations are Benefited once per tooth on the occlusal surface of permanent first and second molars for Patients through age fifteen (15). The teeth must be free from caries or restorations on the occlusal surface. A sealant or preventive resin restoration done on the same date of service and on the same surface as a restoration is considered a component of the restoration, and the fee for the sealant or preventive resin restoration is Disallowed.
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