Most common D4365 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 Accession of tissue, gross examination, preparation and transmission of written report.
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.
Separation of one or more connections between abutments and/or pontics when some portion of a fixed rosthesis is to remain intact D4365 and serviceable following sectioning and extraction or other treatment Includes all recontouring and olishing of retained portions.
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.
Sealant repair - per tooth - This procedure is disallowed when performed by the same dentist/dental office based on the same time limitation that exists for replacement of a sealant. It is allowed at 50% of D4365 when performed by a different provider or if after the time limitation for the same dentist.
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