DEN 491 Procedure code, description and points 2007-2008 - updated

Procedure Code Procedure Description Procedure Points

Preventive
D1110 Prophy 1.0
D1204 Fluoride 0.5
D1310 Nutritional counseling 0.5
D1320 Tobacco counseling 0.5
D1330 Oral hygiene instructions 0.5
D1351 Sealant - Maxillary 0.25
D1352 Sealant - Mandibular 0.25

Restorative
D2000 Restorative diagnosis & TX plan 1.0
D2140 Amalgam - 1 surface 0.5
D2150 Amalgam - 2 surfaces 1.0
D2160 Amalgam - 3 surfaces 1.0
D2161 Amalgam - 4 or more surfaces 1.5
D2161 Finishing & polishing Amalgam 0.0
D2330 Resin-based comp-1 surf 0.5
D2331 Resin-based comp-2 surf 1.0
D2332 Resin-based comp-3 surf 1.0
D2335 Resin-based comp-4+surf 1.5
D2337 Preventive Resin restoration 0.3
D2340 Glass Ionomer restoration 0.5
D2510 Inlay - metallic - 1 surface 2.0
D2520 Inlay - metallic - 2 surfaces 2.0
D2530 Inlay - metallic - 3 or more 2.0
D2542 Onlay - metallic - 2 surfaces 2.0
D2543 Onlay - metallic - 3 surfaces 2.0
D2544 Onlay - metallic - 4 or more 2.0
D2610 Inlay - porc/cer/resin - 1 surface 2.0
D2620 Inlay - porc/cer/resin - 2 surfaces 2.0
D2630 Inlay - porc/cer/resin - 3 or more 2.0
D2642 Onlay - porc/cer/resin - 2 surfaces 2.0
D2643 Onlay - porc/cer/resin - 3 surfaces 2.0
D2644 Onlay - porc/cer/resin - 4 or more 2.0
D2910 Recement Inlay 0.0
D2940 Sedative filling 0.0
D2950 Core buildup - including pins 1.5
D2960 Labial veneer, resin-chairside 1.5
D2961 Labial veneer, resin-lab 2.0
D2962 Labial veneer, porcelain-lab 2.0
D2999 Unspecified restorative proc. By Instructor

Endodontics
D3000 Endodontics diagnosis & TX plan 1.0
D3110 Pulp Cap, Direct 0.0
D3120 Pulp Cap, Indirect 0.0
D3220 Theraputic pulpotomy 0.0
D3221 Pulpal debridement 0.0
D3310 Endo therapy - anterior 1.5
D3320 Endo therapy - bicuspid 2.0
D3330 Endo therapy - molar 3.0
D3331 Endo-Rt canal obstruc-non surg 1.0
D3332 Endo-Incompl inop/fract tooth 1.0
D3333 Endo - internal root repair 1.0
D3346 Anterior RC Retreat 2
D3347 Bicuspid RC Retreat 2.5
D3348 Molar RC Retreat 3.5
D3351 Apex/recalc 1
D3410 Apicoectomy - anterior 1.0
D3421 Apicoectomy – bicusp 1.0
D3425 Apicoectomy - molar 1.0
D3430 Retrograde filling 1.0
D3450 Root amputation 1.5
D3920 Hemisection, incl root removal 1.5
D3999 Unspecified endo procedure By Instructor

Periodontics
D4000 Periodontics diagnosis & TX plan 1.0
D4210 Periodontal Surgery / sextant 0.5
D4341 Scaling & rt planing / sextant 1.0
D4351 Gross Scaling / case 2.0
D4381 Chemotherapy - per tooth 0.0
D4910 Periodontal maintenance 1.0
D4999 Unspecified periodontal proc. By Instructor

Removable Prosthodontics
D5000 Prosthodontics diagnosis & TX plan 1.0
D5110 Complete denture - maxillary 5.0
D5120 Complete denture - mandibular 5.0
D5130 Immediate denture - maxillary 5.0
D5140 Immediate denture - mandibular 5.0
D5213 Max partial - cast metal frame 5.0
D5214 Mand partial - cast metal frame 5.0
D5410 Adjust Complete Dent Max 0.5
D5411 Adjust Complete Dent Mand. 0.5
D5421 Adjust Partial Denture Max. 0.5
D5422 Adjust Partial Denture Mand. 0.5
D5510 Repair denture base 1.0
D5520 Replace teeth 1.0
D5610 Repair resin denture base 1.0
D5630 Repair or replace broken clasp 1.0
D5650 Add tooth to existing partial 1.0
D5660 Add clasp to existing partial 1.0
D5710 Rebase complete max. denture 2.0
D5711 Rebase complete mand. denture 2.0
D5720 Rebase max. partial denture 2.0
D5721 Rebase mand. partial denture 2.0
D5750 Reline comp max - laboratory 2.0
D5751 Reline comp mand - laboratory 2.0
D5760 Reline max part - laboratory 2.0
D5761 Reline mand part - laboratory 2.0
D5810 Interim complete denture - Max 2.0
D5811 Interim complete denture -Mand 2.0
D5820 Interim partial denture - Max 2.0
D5821 Interim partial denture - Mand 2.0
D5850 Tissue conditioning - Max. 0.5
D5851 Tissue conditioning - Mand. 0.5
D5860 Overdenture - complete 6.0
D5861 Overdenture - partial 6.0
D5862 Attachment / arch 1.0
D5899 Unspecified removable prosth. proc. By Instructor

Implant Prosthodontics
D6010 Surg placement, endosteal impl 1.0
D6053 Implt/abut denture, comp edent 6.0
D6054 Implt/abut denture, part edent 6.0
D6055 Dental implant supported bar 2.0
D6065 Implant - porc/ceramic crown 5.0
D6066 Implant – MC crown 5.0
D6067 Implant -metal crown 5.0
D6076 Implant - retainer for MC FPD 5.0
D6080 Implant maintenance proc. 1.0
D6100 Implant removal 1.0
D6199 Unspecified implant proc. By Instructor

Fixed Prosthodontics
D6210 Pontic - cast metal 2.0
D6220 Pontic - porcelain/ceramic 2.0
D6240 Pontic - MC 2.0
D6241 Retainer FPD - cast metal 4.0
D6242 Retainer FPD - porcelain/ceramic 4.0
D6243 Retainer FPD - MC 4.0
D6545 Retainer, metal, resin bond FP 2.0
D6548 Retainer, porc/cera, bonded FP 2.0
D6740 Crown - porcelain/ceramic 4.0
D6750 Crown - MC 4.0
D6780 Crown- 3/4 cast metal 4.0
D6790 Crown- cast metal 4.0
D6800 Surveyed Crown/Retainer 5.0
D6930 Recement FPD 0.5
D6931 Recement crown 0.5
D6932 Recement post and core 0.5
D6940 Stress breaker 1.0
D6950 Precision attachment 1.0
D6970 Cast post & core 2.0
D6971 Prefab post and core 2.0
D6973 Core build up for ret. w/ pins 1.5
D6974 Post removal 1.0
D6975 Crown/ Retainer removal 1.0
D6980 FPD repair 1.0
D6999 Unspecified fixed pros. proc. By Instructor

Surgery
D7000 Surgery diagnosis & TX plan 1.0
D7140 Extraction, eruptd tth/ exp rt 0.5
D7210 Surg removal of erupted tooth 1.0
D7220 Rem of impacted tth, soft tiss 1.5
D7230 Rem of impacted tth, part bony 2.0
D7240 Rem of impacted tth, comp bony 2.5
D7250 Removal of residual tth roots 1.0
D7285 Biopsy of oral tissue - hard 1.0
D7286 Biospy of oral tissue - soft 1.0
D7287 Cytology sample collection 1.0
D7310 Alveoloplasty 1.0
D7340 Vestibuloplasty - second epith 1.0
D7350 Vestibuloplasty -tissue grafts 1.0
D7410 Excision, benign lesion 1.0
D7413 Excision, malig lesion 1.0
D7450 Rem odonto cyst/tumor 1.0
D7460 Rem nonodonto cyst 1.0
D7471 Removal of lateral exostosis 1.0
D7472 Removal of torus palatinus 1.0
D7473 Removal of torus mandibularis 1.0
D7485 Surg reduct of osseous tuberos 1.0
D7510 Incision/drainage,abscess-intr 1.0
D7960 Frenulectomy - separate proc. 1.0
D7970 Excision - hyperplastic tiss 1.0
D7971 Excision - pericoronal gingiva 1.0
D7999 Unspecified oral surgery proc. By Instructor

Miscellaneous
D9910 Applicate desensitizing medica 0.5
D9911 Applicate desens resin-per tth 0.5
D9920 Behavior management 1.0
D9940 Occlusal night guard 1.0
D9950 Occlusion analysis-mountd case 1.0
D9951 Occlusal adjustment - limited 1.0
D9952 Occlusal adjustment - complete 2.0
D9973 External bleaching - per tooth 0.25
D9974 Internal bleaching - per tooth 0.25
D9976 Recall and Maintenance appointment 3-6 months 1.0
D9999 Unspecified adjunctive proc. By Instructor