Most common D5013 code reviews : Removal of fixed orthodontic appliances for reasons other than completion of treatment - not covered, Non-ionizing diagnostic procedure capable of quantifying, monitoring and recording changes in structure of enamel, dentin and cementum or Resin-based composite - four or more surfaces or involving the incisal angle (anterior).
Sealant-per 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 orrestorations 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.
Procedure in D5013 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.
There is a succedaneous tooth #29 present on a radiograph, but it will be several years before it erupts Endodontic treatment is requested on tooth T in order to maintain this tooth and its space in the arch Treatment is performed on the tooth, and the canals are filled with a resorbable material. A temporary restoration is placed, and the patient is referred back to the referring dentist for a final restoration.
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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