{
"description": null,
"_filename": "codesystem-cdt.json",
"package_name": "tiga.health.clinical",
"date": null,
"publisher": null,
"content": "complete",
"name": "CDT, The Code on Dental Procedures and Nomenclature, produced by American Dental Association (ADA)",
"type": null,
"experimental": null,
"resourceType": "CodeSystem",
"title": null,
"package_version": "1.1.0",
"status": "active",
"hierarchyMeaning": "is-a",
"id": "f8d7b9bc-5b8d-4caa-b228-f21d826dbd13",
"kind": null,
"url": "https://www.ama-assn.org/cdt",
"concept": [ {
"code": "CDT",
"concept": [ {
"code": "D0120-D0999",
"concept": [ {
"code": "D0120-D0180",
"concept": [ {
"code": "D0120",
"display": "periodic oral evaluation - established patient"
}, {
"code": "D0140",
"display": "limited oral evaluation - problem focused"
}, {
"code": "D0145",
"display": "oral evaluation for a patient under three years of age and counseling with primary caregiver"
}, {
"code": "D0150",
"display": "comprehensive oral evaluation - new or established patient"
}, {
"code": "D0160",
"display": "detailed and extensive oral evaluation - problem focused, by report"
}, {
"code": "D0170",
"display": "re-evaluation - limited, problem focused (established patient; not post-operative visit)"
}, {
"code": "D0171",
"display": "re-evaluation - post-operative office visit"
}, {
"code": "D0180",
"display": "comprehensive periodontal evaluation - new or established patient"
} ],
"display": "CLINICAL ORAL EVALUATIONS"
}, {
"code": "D0190-D0191",
"concept": [ {
"code": "D0190",
"display": "screening of a patient"
}, {
"code": "D0191",
"display": "assessment of a patient"
} ],
"display": "PRE-DIAGNOSTIC SERVICES"
}, {
"code": "D0210-D0709",
"concept": [ {
"code": "D0210-D0371",
"concept": [ {
"code": "D0210",
"display": "intraoral - complete series of radiographic images"
}, {
"code": "D0220",
"display": "intraoral - periapical first radiographic image"
}, {
"code": "D0230",
"display": "intraoral - periapical each additional radiographic image"
}, {
"code": "D0240",
"display": "intraoral - occlusal radiographic image"
}, {
"code": "D0250",
"display": "extra-oral - 2D projection radiographic image created using a stationary radiation source, and detector"
}, {
"code": "D0251",
"display": "extra-oral posterior dental radiographic image"
}, {
"code": "D0270",
"display": "bitewing - single radiographic image"
}, {
"code": "D0272",
"display": "bitewings - two radiographic images"
}, {
"code": "D0273",
"display": "bitewings - three radiographic images"
}, {
"code": "D0274",
"display": "bitewings - four radiographic images"
}, {
"code": "D0277",
"display": "vertical bitewings - 7 to 8 radiographic images"
}, {
"code": "D0310",
"display": "sialography"
}, {
"code": "D0320",
"display": "temporomandibular joint arthrogram, including injection"
}, {
"code": "D0321",
"display": "other temporomandibular joint radiographic images, by report"
}, {
"code": "D0322",
"display": "tomographic survey"
}, {
"code": "D0330",
"display": "panoramic radiographic image"
}, {
"code": "D0340",
"display": "2D cephalometric radiographic image - acquisition, measurement and analysis"
}, {
"code": "D0350",
"display": "2D oral/facial photographic image obtained intra-orally or extra-orally"
}, {
"code": "D0351",
"display": "3D photographic image"
}, {
"code": "D0364",
"display": "cone beam CT capture and interpretation with limited field of view - less than one whole jaw"
}, {
"code": "D0365",
"display": "cone beam CT capture and interpretation with field of view of one full dental arch - mandible"
}, {
"code": "D0366",
"display": "cone beam CT capture and interpretation with field of view of one full dental arch - maxilla, with or without cranium"
}, {
"code": "D0367",
"display": "cone beam CT capture and interpretation with field of view of both jaws; with or without cranium"
}, {
"code": "D0368",
"display": "cone beam CT capture and interpretation for TMJ series including two or more exposures"
}, {
"code": "D0369",
"display": "maxillofacial MRI capture and interpretation"
}, {
"code": "D0370",
"display": "maxillofacial ultrasound capture and interpretation"
}, {
"code": "D0371",
"display": "sialoendoscopy capture and interpretation"
} ],
"display": "IMAGE CAPTURE WITH INTERPRETATION"
}, {
"code": "D0380-D0709",
"concept": [ {
"code": "D0380",
"display": "cone beam CT image capture with limited field of view - less than one whole jaw"
}, {
"code": "D0381",
"display": "cone beam CT image capture with field of view of one full dental arch - mandible"
}, {
"code": "D0382",
"display": "cone beam CT image capture with field of view of one full dental arch - maxilla, with or without cranium"
}, {
"code": "D0383",
"display": "cone beam CT image capture with field of view of both jaws; with or without cranium"
}, {
"code": "D0384",
"display": "cone beam CT image capture for TMJ series including two or more exposures"
}, {
"code": "D0385",
"display": "maxillofacial MRI image capture"
}, {
"code": "D0386",
"display": "maxillofacial ultrasound image capture"
}, {
"code": "D0701",
"display": "panoramic radiographic image - image capture only"
}, {
"code": "D0702",
"display": "2-D cephalometric radiographic image - image capture only"
}, {
"code": "D0703",
"display": "2-D oral/facial photographic image obtained intra-orally or extra-orally - image capture only"
}, {
"code": "D0704",
"display": "3-D photographic image - image capture only"
}, {
"code": "D0705",
"display": "extra-oral posterior dental radiographic image - image capture only"
}, {
"code": "D0706",
"display": "intraoral - occlusal radiographic image - image capture only"
}, {
"code": "D0707",
"display": "intraoral - periapical radiographic image - image capture only"
}, {
"code": "D0708",
"display": "intraoral - bitewing radiographic image - image capture only"
}, {
"code": "D0709",
"display": "intraoral - complete series of radiographic images - image capture only"
} ],
"display": "IMAGE CAPTURE ONLY"
}, {
"code": "D0391-D0391",
"concept": [ {
"code": "D0391",
"display": "interpretation of diagnostic image by a practitioner not associated with capture of the image, including report"
} ],
"display": "INTERPRETATION AND REPORT ONLY"
}, {
"code": "D0393-D0395",
"concept": [ {
"code": "D0393",
"display": "treatment simulation using 3D image volume"
}, {
"code": "D0394",
"display": "digital subtraction of two or more images or image volumes of the same modality"
}, {
"code": "D0395",
"display": "fusion of two or more 3D image volumes of one or more modalities"
} ],
"display": "POST PROCESSING OF IMAGE OR IMAGE SETS"
} ],
"display": "DIAGNOSTIC IMAGING"
}, {
"code": "D0411-D0605",
"concept": [ {
"code": "D0411",
"display": "HbA1c in-office point of service testing"
}, {
"code": "D0412",
"display": "blood glucose level test - in-office using a glucose meter"
}, {
"code": "D0414",
"display": "laboratory processing of microbial specimen to include culture and sensitivity studies, preparation and transmission of written report"
}, {
"code": "D0415",
"display": "collection of microorganisms for culture and sensitivity"
}, {
"code": "D0416",
"display": "viral culture"
}, {
"code": "D0417",
"display": "collection and preparation of saliva sample for laboratory diagnostic testing"
}, {
"code": "D0418",
"display": "analysis of saliva sample"
}, {
"code": "D0419",
"display": "assessment of salivary flow by measurement"
}, {
"code": "D0422",
"display": "collection and preparation of genetic sample material for laboratory analysis and report"
}, {
"code": "D0423",
"display": "genetic test for susceptibility to diseases - specimen analysis"
}, {
"code": "D0425",
"display": "caries susceptibility tests"
}, {
"code": "D0431",
"display": "adjunctive pre-diagnostic test that aids in detection of mucosal abnormalities including premalignant and malignant lesions, not to include cytology or biopsy procedures"
}, {
"code": "D0460",
"display": "pulp vitality tests"
}, {
"code": "D0470",
"display": "diagnostic casts"
}, {
"code": "D0600",
"display": "non-ionizing diagnostic procedure capable of quantifying, monitoring, and recording changes in structure of enamel, dentin, and cementum"
}, {
"code": "D0601",
"display": "caries risk assessment and documentation, with a finding of low risk"
}, {
"code": "D0602",
"display": "caries risk assessment and documentation, with a finding of moderate risk"
}, {
"code": "D0603",
"display": "caries risk assessment and documentation, with a finding of high risk"
}, {
"code": "D0604",
"display": "antigen testing for a public health related pathogen, including coronavirus"
}, {
"code": "D0605",
"display": "antibody testing for a public health related pathogen, including coronavirus"
} ],
"display": "TESTS AND EXAMINATIONS"
}, {
"code": "D0472-D0502",
"concept": [ {
"code": "D0472",
"display": "accession of tissue, gross examination, preparation and transmission of written report"
}, {
"code": "D0473",
"display": "accession of tissue, gross and microscopic examination, preparation and transmission of written report"
}, {
"code": "D0474",
"display": "accession of tissue, gross and microscopic examination, including assessment of surgical margins for presence of disease, preparation and transmission of written report"
}, {
"code": "D0475",
"display": "decalcification procedure"
}, {
"code": "D0476",
"display": "special stains for microorganisms"
}, {
"code": "D0477",
"display": "special stains, not for microorganisms"
}, {
"code": "D0478",
"display": "immunohistochemical stains"
}, {
"code": "D0479",
"display": "tissue in-situ hybridization, including interpretation"
}, {
"code": "D0480",
"display": "accession of exfoliative cytologic smears, microscopic examination, preparation and transmission of written report"
}, {
"code": "D0481",
"display": "electron microscopy"
}, {
"code": "D0482",
"display": "direct immunofluorescence"
}, {
"code": "D0483",
"display": "indirect immunofluorescence"
}, {
"code": "D0484",
"display": "consultation on slides prepared elsewhere"
}, {
"code": "D0485",
"display": "consultation, including preparation of slides from biopsy material supplied by referring source"
}, {
"code": "D0486",
"display": "laboratory accession of transepithelial cytologic sample, microscopic examination, preparation and transmission of written report"
}, {
"code": "D0502",
"display": "other oral pathology procedures, by report"
} ],
"display": "ORAL PATHOLOGY LABORATORY (USE CODES D0472 - D0502)"
}, {
"code": "D0999",
"display": "unspecified diagnostic procedure, by report"
} ],
"display": "DIAGNOSTIC"
}, {
"code": "D1110-D1999",
"concept": [ {
"code": "D1110-D1120",
"concept": [ {
"code": "D1110",
"display": "prophylaxis - adult"
}, {
"code": "D1120",
"display": "prophylaxis - child"
} ],
"display": "DENTAL PROPHYLAXIS"
}, {
"code": "D1206-D1208",
"concept": [ {
"code": "D1206",
"display": "topical application of fluoride varnish"
}, {
"code": "D1208",
"display": "topical application of fluoride - excluding varnish"
} ],
"display": "TOPICAL FLUORIDE TREATMENT (OFFICE PROCEDURE)"
}, {
"code": "D1310-D1355",
"concept": [ {
"code": "D1310",
"display": "nutritional counseling for control of dental disease"
}, {
"code": "D1320",
"display": "tobacco counseling for the control and prevention of oral disease"
}, {
"code": "D1321",
"display": "counseling for the control and prevention of adverse oral, behavioral, and systemic health effects associated with high-risk substance use"
}, {
"code": "D1330",
"display": "oral hygiene instructions"
}, {
"code": "D1351",
"display": "sealant - per tooth"
}, {
"code": "D1352",
"display": "preventive resin restoration in a moderate to high caries risk patient - permanent tooth"
}, {
"code": "D1353",
"display": "sealant repair - per tooth"
}, {
"code": "D1354",
"display": "interim caries arresting medicament application - per tooth"
}, {
"code": "D1355",
"display": "caries preventive medicament application - per tooth"
} ],
"display": "OTHER PREVENTIVE SERVICES"
}, {
"code": "D1510-D1558",
"concept": [ {
"code": "D1510",
"display": "space maintainer - fixed, unilateral - per quadrant"
}, {
"code": "D1516",
"display": "space maintainer - fixed - bilateral, maxillary"
}, {
"code": "D1517",
"display": "space maintainer - fixed - bilateral, mandibular"
}, {
"code": "D1520",
"display": "space maintainer - removable, unilateral - per quadrant"
}, {
"code": "D1526",
"display": "space maintainer - removable - bilateral, maxillary"
}, {
"code": "D1527",
"display": "space maintainer - removable - bilateral, mandibular"
}, {
"code": "D1551",
"display": "re-cement or re-bond bilateral space maintainer - maxillary"
}, {
"code": "D1552",
"display": "re-cement or re-bond bilateral space maintainer - mandibular"
}, {
"code": "D1553",
"display": "re-cement or re-bond unilateral space maintainer - per quadrant"
}, {
"code": "D1556",
"display": "removal of fixed unilateral space maintainer - per quadrant"
}, {
"code": "D1557",
"display": "removal of fixed bilateral space maintainer - maxillary"
}, {
"code": "D1558",
"display": "removal of fixed bilateral space maintainer - mandibular"
} ],
"display": "SPACE MAINTENANCE (PASSIVE APPLIANCES)"
}, {
"code": "D1575-D1575",
"concept": [ {
"code": "D1575",
"display": "distal shoe space maintainer - fixed, unilateral - per quadrant"
} ],
"display": "SPACE MAINTAINERS"
}, {
"code": "D1999",
"display": "unspecified preventive procedure, by report"
} ],
"display": "PREVENTIVE"
}, {
"code": "D2140-D2999",
"concept": [ {
"code": "D2140-D2161",
"concept": [ {
"code": "D2140",
"display": "amalgam - one surface, primary or permanent"
}, {
"code": "D2150",
"display": "amalgam - two surfaces, primary or permanent"
}, {
"code": "D2160",
"display": "amalgam - three surfaces, primary or permanent"
}, {
"code": "D2161",
"display": "amalgam - four or more surfaces, primary or permanent"
} ],
"display": "AMALGAM RESTORATIONS (INCLUDING POLISHING)"
}, {
"code": "D2330-D2394",
"concept": [ {
"code": "D2330",
"display": "resin-based composite - one surface, anterior"
}, {
"code": "D2331",
"display": "resin-based composite - two surfaces, anterior"
}, {
"code": "D2332",
"display": "resin-based composite - three surfaces, anterior"
}, {
"code": "D2335",
"display": "resin-based composite - four or more surfaces or involving incisal angle (anterior)"
}, {
"code": "D2390",
"display": "resin-based composite crown, anterior"
}, {
"code": "D2391",
"display": "resin-based composite - one surface, posterior"
}, {
"code": "D2392",
"display": "resin-based composite - two surfaces, posterior"
}, {
"code": "D2393",
"display": "resin-based composite - three surfaces, posterior"
}, {
"code": "D2394",
"display": "resin-based composite - four or more surfaces, posterior"
} ],
"display": "RESIN-BASED COMPOSITE RESTORATIONS - DIRECT"
}, {
"code": "D2410-D2430",
"concept": [ {
"code": "D2410",
"display": "gold foil - one surface"
}, {
"code": "D2420",
"display": "gold foil - two surfaces"
}, {
"code": "D2430",
"display": "gold foil - three surfaces"
} ],
"display": "GOLD FOIL RESTORATIONS"
}, {
"code": "D2510-D2664",
"concept": [ {
"code": "D2510",
"display": "inlay - metallic - one surface"
}, {
"code": "D2520",
"display": "inlay - metallic - two surfaces"
}, {
"code": "D2530",
"display": "inlay - metallic - three or more surfaces"
}, {
"code": "D2542",
"display": "onlay - metallic - two surfaces"
}, {
"code": "D2543",
"display": "onlay - metallic - three surfaces"
}, {
"code": "D2544",
"display": "onlay - metallic - four or more surfaces"
}, {
"code": "D2610",
"display": "inlay - porcelain/ceramic - one surface"
}, {
"code": "D2620",
"display": "inlay - porcelain/ceramic - two surfaces"
}, {
"code": "D2630",
"display": "inlay - porcelain/ceramic - three or more surfaces"
}, {
"code": "D2642",
"display": "onlay - porcelain/ceramic - two surfaces"
}, {
"code": "D2643",
"display": "onlay - porcelain/ceramic - three surfaces"
}, {
"code": "D2644",
"display": "onlay - porcelain/ceramic - four or more surfaces"
}, {
"code": "D2650",
"display": "inlay - resin-based composite - one surface"
}, {
"code": "D2651",
"display": "inlay - resin-based composite - two surfaces"
}, {
"code": "D2652",
"display": "inlay - resin-based composite - three or more surfaces"
}, {
"code": "D2662",
"display": "onlay - resin-based composite - two surfaces"
}, {
"code": "D2663",
"display": "onlay - resin-based composite - three surfaces"
}, {
"code": "D2664",
"display": "onlay - resin-based composite - four or more surfaces"
} ],
"display": "INLAY/ONLAY RESTORATIONS"
}, {
"code": "D2710-D2799",
"concept": [ {
"code": "D2710",
"display": "crown - resin-based composite (indirect)"
}, {
"code": "D2712",
"display": "crown - ¾ resin-based composite (indirect)"
}, {
"code": "D2720",
"display": "crown - resin with high noble metal"
}, {
"code": "D2721",
"display": "crown - resin with predominantly base metal"
}, {
"code": "D2722",
"display": "crown - resin with noble metal"
}, {
"code": "D2740",
"display": "crown - porcelain/ceramic"
}, {
"code": "D2750",
"display": "crown - porcelain fused to high noble metal"
}, {
"code": "D2751",
"display": "crown - porcelain fused to predominantly base metal"
}, {
"code": "D2752",
"display": "crown - porcelain fused to noble metal"
}, {
"code": "D2753",
"display": "crown - porcelain fused to titanium and titanium alloys"
}, {
"code": "D2780",
"display": "crown - 3/4 cast high noble metal"
}, {
"code": "D2781",
"display": "crown - 3/4 cast predominantly base metal"
}, {
"code": "D2782",
"display": "crown - 3/4 cast noble metal"
}, {
"code": "D2783",
"display": "crown - 3/4 porcelain/ceramic"
}, {
"code": "D2790",
"display": "crown - full cast high noble metal"
}, {
"code": "D2791",
"display": "crown - full cast predominantly base metal"
}, {
"code": "D2792",
"display": "crown - full cast noble metal"
}, {
"code": "D2794",
"display": "crown - titanium and titanium alloys"
}, {
"code": "D2799",
"display": "provisional crown- further treatment or completion of diagnosis necessary prior to final impression"
} ],
"display": "CROWNS - SINGLE RESTORATIONS ONLY"
}, {
"code": "D2910-D2990",
"concept": [ {
"code": "D2910",
"display": "re-cement or re-bond inlay, onlay, veneer or partial coverage restoration"
}, {
"code": "D2915",
"display": "re-cement or re-bond indirectly fabricated or prefabricated post and core"
}, {
"code": "D2920",
"display": "re-cement or re-bond crown"
}, {
"code": "D2921",
"display": "reattachment of tooth fragment, incisal edge or cusp"
}, {
"code": "D2928",
"display": "prefabricated porcelain/ceramic crown - permanent tooth"
}, {
"code": "D2929",
"display": "prefabricated porcelain/ceramic crown - primary tooth"
}, {
"code": "D2930",
"display": "prefabricated stainless steel crown - primary tooth"
}, {
"code": "D2931",
"display": "prefabricated stainless steel crown - permanent tooth"
}, {
"code": "D2932",
"display": "prefabricated resin crown"
}, {
"code": "D2933",
"display": "prefabricated stainless steel crown with resin window"
}, {
"code": "D2934",
"display": "prefabricated esthetic coated stainless steel crown - primary tooth"
}, {
"code": "D2940",
"display": "protective restoration"
}, {
"code": "D2941",
"display": "interim therapeutic restoration - primary dentition"
}, {
"code": "D2949",
"display": "restorative foundation for an indirect restoration"
}, {
"code": "D2950",
"display": "core buildup, including any pins when required"
}, {
"code": "D2951",
"display": "pin retention - per tooth, in addition to restoration"
}, {
"code": "D2952",
"display": "post and core in addition to crown, indirectly fabricated"
}, {
"code": "D2953",
"display": "each additional indirectly fabricated post - same tooth"
}, {
"code": "D2954",
"display": "prefabricated post and core in addition to crown"
}, {
"code": "D2955",
"display": "post removal"
}, {
"code": "D2957",
"display": "each additional prefabricated post - same tooth"
}, {
"code": "D2960",
"display": "labial veneer (resin laminate) - direct"
}, {
"code": "D2961",
"display": "labial veneer (resin laminate) - indirect"
}, {
"code": "D2962",
"display": "labial veneer (porcelain laminate) - indirect"
}, {
"code": "D2971",
"display": "additional procedures to construct new crown under existing partial denture framework"
}, {
"code": "D2975",
"display": "coping"
}, {
"code": "D2980",
"display": "crown repair necessitated by restorative material failure"
}, {
"code": "D2981",
"display": "inlay repair necessitated by restorative material failure"
}, {
"code": "D2982",
"display": "onlay repair necessitated by restorative material failure"
}, {
"code": "D2983",
"display": "veneer repair necessitated by restorative material failure"
}, {
"code": "D2990",
"display": "resin infiltration of incipient smooth surface lesions"
} ],
"display": "OTHER RESTORATIVE SERVICES"
}, {
"code": "D2999",
"display": "unspecified restorative procedure, by report"
} ],
"display": "RESTORATIVE"
}, {
"code": "D3110-D3999",
"concept": [ {
"code": "D3110-D3120",
"concept": [ {
"code": "D3110",
"display": "pulp cap - direct (excluding final restoration)"
}, {
"code": "D3120",
"display": "pulp cap - indirect (excluding final restoration)"
} ],
"display": "PULP CAPPING"
}, {
"code": "D3220-D3222",
"concept": [ {
"code": "D3220",
"display": "therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction and application of medicament"
}, {
"code": "D3221",
"display": "pulpal debridement, primary and permanent teeth"
}, {
"code": "D3222",
"display": "partial pulpotomy for apexogenesis - permanent tooth with incomplete root development"
} ],
"display": "PULPOTOMY"
}, {
"code": "D3230-D3240",
"concept": [ {
"code": "D3230",
"display": "pulpal therapy (resorbable filling) - anterior, primary tooth (excluding final restoration)"
}, {
"code": "D3240",
"display": "pulpal therapy (resorbable filling) - posterior, primary tooth (excluding final restoration)"
} ],
"display": "ENDODONTIC THERAPY ON PRIMARY TEETH"
}, {
"code": "D3310-D3333",
"concept": [ {
"code": "D3310",
"display": "endodontic therapy, anterior tooth (excluding final restoration)"
}, {
"code": "D3320",
"display": "endodontic therapy, premolar tooth (excluding final restoration)"
}, {
"code": "D3330",
"display": "endodontic therapy, molar tooth (excluding final restoration)"
}, {
"code": "D3331",
"display": "treatment of root canal obstruction; non-surgical access"
}, {
"code": "D3332",
"display": "incomplete endodontic therapy; inoperable, unrestorable or fractured tooth"
}, {
"code": "D3333",
"display": "internal root repair of perforation defects"
} ],
"display": "ENDODONTIC THERAPY (INCLUDING TREATMENT PLAN, CLINICAL PROCEDURES AND FOLLOW-UP CARE)"
}, {
"code": "D3346-D3348",
"concept": [ {
"code": "D3346",
"display": "retreatment of previous root canal therapy - anterior"
}, {
"code": "D3347",
"display": "retreatment of previous root canal therapy - premolar"
}, {
"code": "D3348",
"display": "retreatment of previous root canal therapy - molar"
} ],
"display": "ENDODONTIC RETREATMENT"
}, {
"code": "D3351-D3353",
"concept": [ {
"code": "D3351",
"display": "apexification/recalcification - initial visit (apical closure/calcific repair of perforations, root resorption, etc.)"
}, {
"code": "D3352",
"display": "apexification/recalcification - interim medication replacement"
}, {
"code": "D3353",
"display": "apexification/recalcification - final visit (includes completed root canal therapy - apical closure/calcific repair of perforations, root resorption, etc.)"
} ],
"display": "APEXIFICATION/RECALCIFICATION"
}, {
"code": "D3355-D3357",
"concept": [ {
"code": "D3355",
"display": "pulpal regeneration - initial visit"
}, {
"code": "D3356",
"display": "pulpal regeneration - interim medication replacement"
}, {
"code": "D3357",
"display": "pulpal regeneration - completion of treatment"
} ],
"display": "PULPAL REGENERATION"
}, {
"code": "D3410-D3503",
"concept": [ {
"code": "D3410",
"display": "apicoectomy - anterior"
}, {
"code": "D3421",
"display": "apicoectomy - premolar (first root)"
}, {
"code": "D3425",
"display": "apicoectomy - molar (first root)"
}, {
"code": "D3426",
"display": "apicoectomy (each additional root)"
}, {
"code": "D3428",
"display": "bone graft in conjunction with periradicular surgery - per tooth, single site"
}, {
"code": "D3429",
"display": "bone graft in conjunction with periradicular surgery - each additional contiguous tooth in the same surgical site"
}, {
"code": "D3430",
"display": "retrograde filling - per root"
}, {
"code": "D3431",
"display": "biologic materials to aid in soft and osseous tissue regeneration in conjunction with periradicular surgery"
}, {
"code": "D3432",
"display": "guided tissue regeneration, resorbable barrier, per site, in conjunction with periradicular surgery"
}, {
"code": "D3450",
"display": "root amputation - per root"
}, {
"code": "D3460",
"display": "endodontic endosseous implant"
}, {
"code": "D3470",
"display": "intentional re-implantation (including necessary splinting)"
}, {
"code": "D3471",
"display": "surgical repair of root resorption - anterior"
}, {
"code": "D3472",
"display": "surgical repair of root resorption - premolar"
}, {
"code": "D3473",
"display": "surgical repair of root resorption - molar"
}, {
"code": "D3501",
"display": "surgical exposure of root surface without apicoectomy or repair of root resorption - anterior"
}, {
"code": "D3502",
"display": "surgical exposure of root surface without apicoectomy or repair of root resorption - premolar"
}, {
"code": "D3503",
"display": "surgical exposure of root surface without apicoectomy or repair of root resorption - molar"
} ],
"display": "APICOECTOMY/PERIRADICULAR SERVICES"
}, {
"code": "D3910-D3950",
"concept": [ {
"code": "D3910",
"display": "surgical procedure for isolation of tooth with rubber dam"
}, {
"code": "D3920",
"display": "hemisection (including any root removal), not including root canal therapy"
}, {
"code": "D3950",
"display": "canal preparation and fitting of preformed dowel or post"
} ],
"display": "OTHER ENDODONTIC PROCEDURES"
}, {
"code": "D3999",
"display": "unspecified endodontic procedure, by report"
} ],
"display": "ENDODONTICS"
}, {
"code": "D4210-D4999",
"concept": [ {
"code": "D4210-D4285",
"concept": [ {
"code": "D4210",
"display": "gingivectomy or gingivoplasty - four or more contiguous teeth or tooth bounded spaces per quadrant"
}, {
"code": "D4211",
"display": "gingivectomy or gingivoplasty - one to three contiguous teeth or tooth bounded spaces per quadrant"
}, {
"code": "D4212",
"display": "gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth"
}, {
"code": "D4230",
"display": "anatomical crown exposure - four or more contiguous teeth or tooth bounded spaces per quadrant"
}, {
"code": "D4231",
"display": "anatomical crown exposure - one to three teeth or tooth bounded spaces per quadrant"
}, {
"code": "D4240",
"display": "gingival flap procedure, including root planing - four or more contiguous teeth or tooth bounded spaces per quadrant"
}, {
"code": "D4241",
"display": "gingival flap procedure, including root planing - one to three contiguous teeth or tooth bounded spaces per quadrant"
}, {
"code": "D4245",
"display": "apically positioned flap"
}, {
"code": "D4249",
"display": "clinical crown lengthening - hard tissue"
}, {
"code": "D4260",
"display": "osseous surgery (including elevation of a full thickness flap and closure) - four or more contiguous teeth or tooth bounded spaces per quadrant"
}, {
"code": "D4261",
"display": "osseous surgery (including elevation of a full thickness flap and closure) - one to three contiguous teeth or tooth bounded spaces per quadrant"
}, {
"code": "D4263",
"display": "bone replacement graft - retained natural tooth - first site in quadrant"
}, {
"code": "D4264",
"display": "bone replacement graft - retained natural tooth - each additional site in quadrant"
}, {
"code": "D4265",
"display": "biologic materials to aid in soft and osseous tissue regeneration"
}, {
"code": "D4266",
"display": "guided tissue regeneration - resorbable barrier, per site"
}, {
"code": "D4267",
"display": "guided tissue regeneration - nonresorbable barrier, per site (includes membrane removal)"
}, {
"code": "D4268",
"display": "surgical revision procedure, per tooth"
}, {
"code": "D4270",
"display": "pedicle soft tissue graft procedure"
}, {
"code": "D4273",
"display": "autogenous connective tissue graft procedure (including donor and recipient surgical sites) first tooth, implant, or edentulous tooth position in graft"
}, {
"code": "D4274",
"display": "mesial/distal wedge procedure, single tooth (when not performed in conjunction with surgical procedures in the same anatomical area)"
}, {
"code": "D4275",
"display": "non-autogenous connective tissue graft (including recipient site and donor material) first tooth, implant, or edentulous tooth position in graft"
}, {
"code": "D4276",
"display": "combined connective tissue and double pedicle graft, per tooth"
}, {
"code": "D4277",
"display": "free soft tissue graft procedure (including recipient and donor surgical sites) first tooth, implant or edentulous tooth position in graft"
}, {
"code": "D4278",
"display": "free soft tissue graft procedure (including recipient and donor surgical sites) each additional contiguous tooth, implant or edentulous tooth position in same graft site"
}, {
"code": "D4283",
"display": "autogenous connective tissue graft procedure (including donor and recipient surgical sites) - each additional contiguous tooth, implant or edentulous tooth position in same graft site"
}, {
"code": "D4285",
"display": "non-autogenous connective tissue graft procedure (including recipient surgical site and donor material) - each additional contiguous tooth, implant or edentulous tooth position in same graft site"
} ],
"display": "SURGICAL SERVICES (INCLUDING USUAL POSTOPERATIVE CARE)"
}, {
"code": "D4320-D4381",
"concept": [ {
"code": "D4320",
"display": "provisional splinting - intracoronal"
}, {
"code": "D4321",
"display": "provisional splinting - extracoronal"
}, {
"code": "D4341",
"display": "periodontal scaling and root planing - four or more teeth per quadrant"
}, {
"code": "D4342",
"display": "periodontal scaling and root planing - one to three teeth per quadrant"
}, {
"code": "D4346",
"display": "scaling in presence of generalized moderate or severe gingival inflammation - full mouth, after oral evaluation"
}, {
"code": "D4355",
"display": "full mouth debridement to enable a comprehensive oral evaluation and diagnosis on a subsequent visit"
}, {
"code": "D4381",
"display": "localized delivery of antimicrobial agents via a controlled release vehicle into diseased crevicular tissue, per tooth"
} ],
"display": "NON-SURGICAL PERIODONTAL SERVICE"
}, {
"code": "D4910-D4921",
"concept": [ {
"code": "D4910",
"display": "periodontal maintenance"
}, {
"code": "D4920",
"display": "unscheduled dressing change (by someone other than treating dentist or their staff)"
}, {
"code": "D4921",
"display": "gingival irrigation - per quadrant"
} ],
"display": "OTHER PERIODONTAL SERVICES"
}, {
"code": "D4999",
"display": "unspecified periodontal procedure, by report"
} ],
"display": "PERIODONTICS"
}, {
"code": "D5110-D5899",
"concept": [ {
"code": "D5110-D5140",
"concept": [ {
"code": "D5110",
"display": "complete denture - maxillary"
}, {
"code": "D5120",
"display": "complete denture - mandibular"
}, {
"code": "D5130",
"display": "immediate denture - maxillary"
}, {
"code": "D5140",
"display": "immediate denture - mandibular"
} ],
"display": "COMPLETE DENTURES (INCLUDING ROUTINE POST-DELIVERY CARE)"
}, {
"code": "D5211-D5286",
"concept": [ {
"code": "D5211",
"display": "maxillary partial denture - resin base (including, retentive/clasping materials, rests, and teeth)"
}, {
"code": "D5212",
"display": "mandibular partial denture - resin base (including, retentive/clasping materials, rests, and teeth)"
}, {
"code": "D5213",
"display": "maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)"
}, {
"code": "D5214",
"display": "mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)"
}, {
"code": "D5221",
"display": "immediate maxillary partial denture - resin base (including retentive/clasping materials, rests and teeth)"
}, {
"code": "D5222",
"display": "immediate mandibular partial denture - resin base (including retentive/clasping materials, rests and teeth)"
}, {
"code": "D5223",
"display": "immediate maxillary partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)"
}, {
"code": "D5224",
"display": "immediate mandibular partial denture - cast metal framework with resin denture bases (including retentive/clasping materials, rests and teeth)"
}, {
"code": "D5225",
"display": "maxillary partial denture - flexible base (including retentive/clasping materials, rests, and teeth)"
}, {
"code": "D5226",
"display": "mandibular partial denture - flexible base (including retentive/clasping materials, rests, and teeth)"
}, {
"code": "D5282",
"display": "removable unilateral partial denture - one piece cast metal (including retentive/clasping materials, rests, and teeth), maxillary"
}, {
"code": "D5283",
"display": "removable unilateral partial denture - one piece cast metal (including rententive/clasping materias, rests, and teeth), mandibular"
}, {
"code": "D5284",
"display": "removable unilateral partial denture - one piece flexible base (including retentive/clasping materials, rests, and teeth) - per quadrant"
}, {
"code": "D5286",
"display": "removable unilateral partial denture - one piece resin (including retentive/clasping materials, rests, and teeth) - per quadrant"
} ],
"display": "PARTIAL DENTURES (INCLUDING ROUTINE POST-DELIVERY CARE)"
}, {
"code": "D5410-D5422",
"concept": [ {
"code": "D5410",
"display": "adjust complete denture - maxillary"
}, {
"code": "D5411",
"display": "adjust complete denture - mandibular"
}, {
"code": "D5421",
"display": "adjust partial denture - maxillary"
}, {
"code": "D5422",
"display": "adjust partial denture - mandibular"
} ],
"display": "ADJUSTMENTS TO DENTURES"
}, {
"code": "D5511-D5520",
"concept": [ {
"code": "D5511",
"display": "repair broken complete denture base, mandibular"
}, {
"code": "D5512",
"display": "repair broken complete denture base, maxillary"
}, {
"code": "D5520",
"display": "replace missing or broken teeth - complete denture (each tooth)"
} ],
"display": "REPAIRS TO COMPLETE DENTURES"
}, {
"code": "D5611-D5671",
"concept": [ {
"code": "D5611",
"display": "repair resin partial denture base, mandibular"
}, {
"code": "D5612",
"display": "repair resin partial denture base, maxillary"
}, {
"code": "D5621",
"display": "repair cast partial framework, mandibular"
}, {
"code": "D5622",
"display": "repair cast partial framework, maxillary"
}, {
"code": "D5630",
"display": "repair or replace broken retentive clasping materials - per tooth"
}, {
"code": "D5640",
"display": "replace broken teeth - per tooth"
}, {
"code": "D5650",
"display": "add tooth to existing partial denture"
}, {
"code": "D5660",
"display": "add clasp to existing partial denture - per tooth"
}, {
"code": "D5670",
"display": "replace all teeth and acrylic on cast metal framework (maxillary)"
}, {
"code": "D5671",
"display": "replace all teeth and acrylic on cast metal framework (mandibular)"
} ],
"display": "REPAIRS TO PARTIAL DENTURES"
}, {
"code": "D5710-D5721",
"concept": [ {
"code": "D5710",
"display": "rebase complete maxillary denture"
}, {
"code": "D5711",
"display": "rebase complete mandibular denture"
}, {
"code": "D5720",
"display": "rebase maxillary partial denture"
}, {
"code": "D5721",
"display": "rebase mandibular partial denture"
} ],
"display": "DENTURE REBASE PROCEDURES"
}, {
"code": "D5730-D5761",
"concept": [ {
"code": "D5730",
"display": "reline complete maxillary denture (direct)"
}, {
"code": "D5731",
"display": "reline complete mandibular denture (direct)"
}, {
"code": "D5740",
"display": "reline maxillary partial denture (direct)"
}, {
"code": "D5741",
"display": "reline mandibular partial denture (direct)"
}, {
"code": "D5750",
"display": "reline complete maxillary denture (indirect)"
}, {
"code": "D5751",
"display": "reline complete mandibular denture (indirect)"
}, {
"code": "D5760",
"display": "reline maxillary partial denture (indirect)"
}, {
"code": "D5761",
"display": "reline mandibular partial denture (indirect)"
} ],
"display": "DENTURE RELINE PROCEDURES"
}, {
"code": "D5810-D5821",
"concept": [ {
"code": "D5810",
"display": "interim complete denture (maxillary)"
}, {
"code": "D5811",
"display": "interim complete denture (mandibular)"
}, {
"code": "D5820",
"display": "interim partial denture (including retentive/clasping materials, rests, and teeth), maxillary"
}, {
"code": "D5821",
"display": "interim partial denture (including retentive/clasping materials, rests, and teeth), mandibular"
} ],
"display": "INTERIM PROSTHESIS"
}, {
"code": "D5850-D5899",
"concept": [ {
"code": "D5850",
"display": "tissue conditioning, maxillary"
}, {
"code": "D5851",
"display": "tissue conditioning, mandibular"
}, {
"code": "D5862",
"display": "precision attachment, by report"
}, {
"code": "D5863",
"display": "overdenture - complete maxillary"
}, {
"code": "D5864",
"display": "overdenture - partial maxillary"
}, {
"code": "D5865",
"display": "overdenture - complete mandibular"
}, {
"code": "D5866",
"display": "overdenture - partial mandibular"
}, {
"code": "D5867",
"display": "replacement of replaceable part of semi-precision or precision attachment (male or female component)"
}, {
"code": "D5875",
"display": "modification of removable prosthesis following implant surgery"
}, {
"code": "D5876",
"display": "add metal substructure to acrylic full denture (per arch)"
}, {
"code": "D5899",
"display": "unspecified removable prosthodontic procedure, by report"
} ],
"display": "OTHER REMOVABLE PROSTHETIC SERVICES"
} ],
"display": "PROSTHODONTICS (removable)"
}, {
"code": "D5911-D5999",
"concept": [ {
"code": "D5911",
"display": "facial moulage (sectional)"
}, {
"code": "D5912",
"display": "facial moulage (complete)"
}, {
"code": "D5913",
"display": "nasal prosthesis"
}, {
"code": "D5914",
"display": "auricular prosthesis"
}, {
"code": "D5915",
"display": "orbital prosthesis"
}, {
"code": "D5916",
"display": "ocular prosthesis"
}, {
"code": "D5919",
"display": "facial prosthesis"
}, {
"code": "D5922",
"display": "nasal septal prosthesis"
}, {
"code": "D5923",
"display": "ocular prosthesis, interim"
}, {
"code": "D5924",
"display": "cranial prosthesis"
}, {
"code": "D5925",
"display": "facial augmentation implant prosthesis"
}, {
"code": "D5926",
"display": "nasal prosthesis, replacement"
}, {
"code": "D5927",
"display": "auricular prosthesis, replacement"
}, {
"code": "D5928",
"display": "orbital prosthesis, replacement"
}, {
"code": "D5929",
"display": "facial prosthesis, replacement"
}, {
"code": "D5931",
"display": "obturator prosthesis, surgical"
}, {
"code": "D5932",
"display": "obturator prosthesis, definitive"
}, {
"code": "D5933",
"display": "obturator prosthesis, modification"
}, {
"code": "D5934",
"display": "mandibular resection prosthesis with guide flange"
}, {
"code": "D5935",
"display": "mandibular resection prosthesis without guide flange"
}, {
"code": "D5936",
"display": "obturator prosthesis, interim"
}, {
"code": "D5937",
"display": "trismus appliance (not for TMD treatment)"
}, {
"code": "D5951",
"display": "feeding aid"
}, {
"code": "D5952",
"display": "speech aid prosthesis, pediatric"
}, {
"code": "D5953",
"display": "speech aid prosthesis, adult"
}, {
"code": "D5954",
"display": "palatal augmentation prosthesis"
}, {
"code": "D5955",
"display": "palatal lift prosthesis, definitive"
}, {
"code": "D5958",
"display": "palatal lift prosthesis, interim"
}, {
"code": "D5959",
"display": "palatal lift prosthesis, modification"
}, {
"code": "D5960",
"display": "speech aid prosthesis, modification"
}, {
"code": "D5982",
"display": "surgical stent"
}, {
"code": "D5983-D5996",
"concept": [ {
"code": "D5983",
"display": "radiation carrier"
}, {
"code": "D5986",
"display": "fluoride gel carrier"
}, {
"code": "D5991",
"display": "vesiculobullous disease medicament carrier"
}, {
"code": "D5995",
"display": "periodontal medicament carrier with peripheral seal - laboratory processed - maxillary"
}, {
"code": "D5996",
"display": "periodontal medicament carrier with peripheral seal - laboratory processed - mandibular"
} ],
"display": "CARRIERS"
}, {
"code": "D5984",
"display": "radiation shield"
}, {
"code": "D5985",
"display": "radiation cone locator"
}, {
"code": "D5987",
"display": "commissure splint"
}, {
"code": "D5988",
"display": "surgical splint"
}, {
"code": "D5992",
"display": "adjust maxillofacial prosthetic appliance, by report"
}, {
"code": "D5993",
"display": "maintenance and cleaning of a maxillofacial prosthesis (extra- or intra-oral) other than required adjustments, by report"
}, {
"code": "D5999",
"display": "unspecified maxillofacial prosthesis, by report"
} ],
"display": "MAXILLOFACIAL PROSTHETICS"
}, {
"code": "D6010-D6199",
"concept": [ {
"code": "D6010-D6104",
"concept": [ {
"code": "D6010",
"display": "surgical placement of implant body: endosteal implant"
}, {
"code": "D6011",
"display": "surgical access to an implant body (second stage implant surgery)"
}, {
"code": "D6012",
"display": "surgical placement of interim implant body for transitional prosthesis: endosteal implant"
}, {
"code": "D6013",
"display": "surgical placement of mini implant"
}, {
"code": "D6040",
"display": "surgical placement: eposteal implant"
}, {
"code": "D6050",
"display": "surgical placement: transosteal implant"
}, {
"code": "D6100",
"display": "implant removal, by report"
}, {
"code": "D6101",
"display": "debridement of a peri-implant defect or defects surrounding a single implant, and surface cleaning of the exposed implant surfaces, including flap entry and closure"
}, {
"code": "D6102",
"display": "debridement and osseous contouring of a peri-implant defect or defects surrounding a single implant and includes surface cleaning of the exposed implant surfaces, including flap entry and closure"
}, {
"code": "D6103",
"display": "bone graft for repair of peri-implant defect - does not include flap entry and closure"
}, {
"code": "D6104",
"display": "bone graft at time of implant placement"
} ],
"display": "SURGICAL SERVICES"
}, {
"code": "D6051-D6199",
"concept": [ {
"code": "D6051-D6192",
"concept": [ {
"code": "D6051",
"display": "interim abutment"
}, {
"code": "D6055",
"display": "connecting bar - implant supported or abutment supported"
}, {
"code": "D6056",
"display": "prefabricated abutment - includes modification and placement"
}, {
"code": "D6057",
"display": "custom fabricated abutment - includes placement"
}, {
"code": "D6191",
"display": "semi-precision abutment - placement"
}, {
"code": "D6192",
"display": "semi-precision attachment - placement"
} ],
"display": "Supporting Structures"
}, {
"code": "D6058-D6097",
"concept": [ {
"code": "D6058",
"display": "abutment supported porcelain/ceramic crown"
}, {
"code": "D6059",
"display": "abutment supported porcelain fused to metal crown (high noble metal)"
}, {
"code": "D6060",
"display": "abutment supported porcelain fused to metal crown (predominantly base metal)"
}, {
"code": "D6061",
"display": "abutment supported porcelain fused to metal crown (noble metal)"
}, {
"code": "D6062",
"display": "abutment supported cast metal crown (high noble metal)"
}, {
"code": "D6063",
"display": "abutment supported cast metal crown (predominantly base metal)"
}, {
"code": "D6064",
"display": "abutment supported cast metal crown (noble metal)"
}, {
"code": "D6094",
"display": "abutment supported crown - titanium and titanium alloys"
}, {
"code": "D6097",
"display": "abutment supported crown - porcelain fused to titanium and titanium alloys"
} ],
"display": "Single Crowns, Abutment Supported"
}, {
"code": "D6065-D6088",
"concept": [ {
"code": "D6065",
"display": "implant supported porcelain/ceramic crown"
}, {
"code": "D6066",
"display": "implant supported crown - porcelain fused to high noble alloys"
}, {
"code": "D6067",
"display": "implant supported crown - high noble alloys"
}, {
"code": "D6082",
"display": "implant supported crown - porcelain fused to predominantly base alloys"
}, {
"code": "D6083",
"display": "implant supported crown - porcelain fused to noble alloys"
}, {
"code": "D6084",
"display": "implant supported crown - porcelain fused to titanium and titanium alloys"
}, {
"code": "D6086",
"display": "implant supported crown - predominantly base alloys"
}, {
"code": "D6087",
"display": "implant supported crown - noble alloys"
}, {
"code": "D6088",
"display": "implant supported crown - titanium and titanium alloys"
} ],
"display": "Single Crowns, Implant Supported"
}, {
"code": "D6068-D6195",
"concept": [ {
"code": "D6068",
"display": "abutment supported retainer for porcelain/ceramic FPD"
}, {
"code": "D6069",
"display": "abutment supported retainer for porcelain fused to metal FPD (high noble metal)"
}, {
"code": "D6070",
"display": "abutment supported retainer for porcelain fused to metal FPD (predominantly base metal)"
}, {
"code": "D6071",
"display": "abutment supported retainer for porcelain fused to metal FPD (noble metal)"
}, {
"code": "D6072",
"display": "abutment supported retainer for cast metal FPD (high noble metal)"
}, {
"code": "D6073",
"display": "abutment supported retainer for cast metal FPD (predominantly base metal)"
}, {
"code": "D6074",
"display": "abutment supported retainer for cast metal FPD (noble metal)"
}, {
"code": "D6194",
"display": "abutment supported retainer crown for FPD - titanium and titanium alloys"
}, {
"code": "D6195",
"display": "abutment supported retainer - porcelain fused to titanium and titanium alloys"
} ],
"display": "Fixed Partial Denture (FPD) Retainer, Abutment Supported"
}, {
"code": "D6075-D6123",
"concept": [ {
"code": "D6075",
"display": "implant supported retainer for ceramic FPD"
}, {
"code": "D6076",
"display": "implant supported retainer for FPD - porcelain fused to high noble alloys"
}, {
"code": "D6077",
"display": "implant supported retainer for metal FPD - high noble alloys"
}, {
"code": "D6098",
"display": "implant supported retainer - porcelain fused to predominantly base alloys"
}, {
"code": "D6099",
"display": "implant supported retainer for FPD - porcelain fused to noble alloys"
}, {
"code": "D6120",
"display": "implant supported retainer - porcelain fused to titanium and titanium alloys"
}, {
"code": "D6121",
"display": "implant supported retainer for metal FPD - predominantly base alloys"
}, {
"code": "D6122",
"display": "implant supported retainer for metal FPD - noble alloys"
}, {
"code": "D6123",
"display": "implant supported retainer for metal FPD - titanium and titanium alloys"
} ],
"display": "Fixed Partial Denture (FPD) Retainer, Implant Supported"
}, {
"code": "D6110-D6113",
"concept": [ {
"code": "D6110",
"display": "implant /abutment supported removable denture for edentulous arch - maxillary"
}, {
"code": "D6111",
"display": "implant /abutment supported removable denture for edentulous arch - mandibular"
}, {
"code": "D6112",
"display": "implant /abutment supported removable denture for partially edentulous arch - maxillary"
}, {
"code": "D6113",
"display": "implant /abutment supported removable denture for partially edentulous arch - mandibular"
} ],
"display": "Implant/Abutment Supported Removable Dentures"
}, {
"code": "D6114-D6119",
"concept": [ {
"code": "D6114",
"display": "implant /abutment supported fixed denture for edentulous arch - maxillary"
}, {
"code": "D6115",
"display": "implant /abutment supported fixed denture for edentulous arch - mandibular"
}, {
"code": "D6116",
"display": "implant /abutment supported fixed denture for partially edentulous arch - maxillary"
}, {
"code": "D6117",
"display": "implant /abutment supported fixed denture for partially edentulous arch - mandibular"
}, {
"code": "D6118",
"display": "implant/abutment supported interim fixed denture for edentulous arch - mandibular"
}, {
"code": "D6119",
"display": "implant/abutment supported interim fixed denture for edentulous arch - maxillary"
} ],
"display": "Implant /Abutment Supported Fixed Dentures (Hybrid Prosthesis)"
}, {
"code": "D6199",
"display": "unspecified implant procedure, by report"
} ],
"display": "IMPLANT SUPPORTED PROSTHETICS"
}, {
"code": "D6080-D6096",
"concept": [ {
"code": "D6080",
"display": "implant maintenance procedures when prostheses are removed and reinserted, including cleansing of prostheses and abutments"
}, {
"code": "D6081",
"display": "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"
}, {
"code": "D6085",
"display": "provisional implant crown"
}, {
"code": "D6090",
"display": "repair implant supported prosthesis, by report"
}, {
"code": "D6091",
"display": "replacement of replaceable part of semi-precision or precision attachment (male or female component) of implant/abutment supported prosthesis, per attachment"
}, {
"code": "D6092",
"display": "re-cement or re-bond implant/abutment supported crown"
}, {
"code": "D6093",
"display": "re-cement or re-bond implant/abutment supported fixed partial denture"
}, {
"code": "D6095",
"display": "repair implant abutment, by report"
}, {
"code": "D6096",
"display": "remove broken implant retaining screw"
} ],
"display": "OTHER IMPLANT SERVICES"
}, {
"code": "D6190-D6190",
"concept": [ {
"code": "D6190",
"display": "radiographic/surgical implant index, by report"
} ],
"display": "PRE-SURGICAL SERVICES"
} ],
"display": "IMPLANT SERVICES"
}, {
"code": "D6205-D6999",
"concept": [ {
"code": "D6205-D6253",
"concept": [ {
"code": "D6205",
"display": "pontic - indirect resin based composite"
}, {
"code": "D6210",
"display": "pontic - cast high noble metal"
}, {
"code": "D6211",
"display": "pontic - cast predominantly base metal"
}, {
"code": "D6212",
"display": "pontic - cast noble metal"
}, {
"code": "D6214",
"display": "pontic - titanium and titanium alloys"
}, {
"code": "D6240",
"display": "pontic - porcelain fused to high noble metal"
}, {
"code": "D6241",
"display": "pontic - porcelain fused to predominantly base metal"
}, {
"code": "D6242",
"display": "pontic - porcelain fused to noble metal"
}, {
"code": "D6243",
"display": "pontic - porcelain fused to titanium and titanium alloys"
}, {
"code": "D6245",
"display": "pontic - porcelain/ceramic"
}, {
"code": "D6250",
"display": "pontic - resin with high noble metal"
}, {
"code": "D6251",
"display": "pontic - resin with predominantly base metal"
}, {
"code": "D6252",
"display": "pontic - resin with noble metal"
}, {
"code": "D6253",
"display": "provisional pontic - further treatment or completion of diagnosis necessary prior to final impression"
} ],
"display": "FIXED PARTIAL DENTURE PONTICS"
}, {
"code": "D6545-D6634",
"concept": [ {
"code": "D6545",
"display": "retainer - cast metal for resin bonded fixed prosthesis"
}, {
"code": "D6548",
"display": "retainer - porcelain/ceramic for resin bonded fixed prosthesis"
}, {
"code": "D6549",
"display": "retainer - for resin bonded fixed prosthesis"
}, {
"code": "D6600",
"display": "retainer inlay - porcelain/ceramic, two surfaces"
}, {
"code": "D6601",
"display": "retainer inlay - porcelain/ceramic, three or more surfaces"
}, {
"code": "D6602",
"display": "retainer inlay - cast high noble metal, two surfaces"
}, {
"code": "D6603",
"display": "retainer inlay - cast high noble metal, three or more surfaces"
}, {
"code": "D6604",
"display": "retainer inlay - cast predominantly base metal, two surfaces"
}, {
"code": "D6605",
"display": "retainer inlay - cast predominantly base metal, three or more surfaces"
}, {
"code": "D6606",
"display": "retainer inlay - cast noble metal, two surfaces"
}, {
"code": "D6607",
"display": "retainer inlay - cast noble metal, three or more surfaces"
}, {
"code": "D6608",
"display": "retainer onlay - porcelain/ceramic, two surfaces"
}, {
"code": "D6609",
"display": "retainer onlay - porcelain/ceramic, three or more surfaces"
}, {
"code": "D6610",
"display": "retainer onlay - cast high noble metal, two surfaces"
}, {
"code": "D6611",
"display": "retainer onlay - cast high noble metal, three or more surfaces"
}, {
"code": "D6612",
"display": "retainer onlay - cast predominantly base metal, two surfaces"
}, {
"code": "D6613",
"display": "retainer onlay - cast predominantly base metal, three or more surfaces"
}, {
"code": "D6614",
"display": "retainer onlay - cast noble metal, two surfaces"
}, {
"code": "D6615",
"display": "retainer onlay - cast noble metal, three or more surfaces"
}, {
"code": "D6624",
"display": "retainer inlay - titanium"
}, {
"code": "D6634",
"display": "retainer onlay - titanium"
} ],
"display": "FIXED PARTIAL DENTURE RETAINERS - INLAYS/ONLAYS"
}, {
"code": "D6710-D6794",
"concept": [ {
"code": "D6710",
"display": "retainer crown - indirect resin based composite"
}, {
"code": "D6720",
"display": "retainer crown - resin with high noble metal"
}, {
"code": "D6721",
"display": "retainer crown - resin with predominantly base metal"
}, {
"code": "D6722",
"display": "retainer crown - resin with noble metal"
}, {
"code": "D6740",
"display": "retainer crown - porcelain/ceramic"
}, {
"code": "D6750",
"display": "retainer crown - porcelain fused to high noble metal"
}, {
"code": "D6751",
"display": "retainer crown - porcelain fused to predominantly base metal"
}, {
"code": "D6752",
"display": "retainer crown - porcelain fused to noble metal"
}, {
"code": "D6753",
"display": "retainer crown - porcelain fused to titanium and titanium alloys"
}, {
"code": "D6780",
"display": "retainer crown - 3/4 cast high noble metal"
}, {
"code": "D6781",
"display": "retainer crown - 3/4 cast predominantly base metal"
}, {
"code": "D6782",
"display": "retainer crown - 3/4 cast noble metal"
}, {
"code": "D6783",
"display": "retainer crown - 3/4 porcelain/ceramic"
}, {
"code": "D6784",
"display": "retainer crown ¾ - titanium and titanium alloys"
}, {
"code": "D6790",
"display": "retainer crown - full cast high noble metal"
}, {
"code": "D6791",
"display": "retainer crown - full cast predominantly base metal"
}, {
"code": "D6792",
"display": "retainer crown - full cast noble metal"
}, {
"code": "D6793",
"display": "provisional retainer crown - further treatment or completion of diagnosis necessary prior to final impression"
}, {
"code": "D6794",
"display": "retainer crown - titanium and titanium alloys"
} ],
"display": "FIXED PARTIAL DENTURE RETAINERS - CROWNS"
}, {
"code": "D6920-D6985",
"concept": [ {
"code": "D6920",
"display": "connector bar"
}, {
"code": "D6930",
"display": "re-cement or re-bond fixed partial denture"
}, {
"code": "D6940",
"display": "stress breaker"
}, {
"code": "D6950",
"display": "precision attachment"
}, {
"code": "D6980",
"display": "fixed partial denture repair necessitated by restorative material failure"
}, {
"code": "D6985",
"display": "pediatric partial denture, fixed"
} ],
"display": "OTHER FIXED PARTIAL DENTURE SERVICES"
}, {
"code": "D6999",
"display": "unspecified fixed prosthodontic procedure, by report"
} ],
"display": "PROSTHODONTICS, fixed"
}, {
"code": "D7111-D7999",
"concept": [ {
"code": "D7111-D7251",
"concept": [ {
"code": "D7111",
"display": "extraction, coronal remnants - primary tooth"
}, {
"code": "D7140",
"display": "extraction, erupted tooth or exposed root (elevation and/or forceps removal)"
}, {
"code": "D7210",
"display": "extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated"
}, {
"code": "D7220",
"display": "removal of impacted tooth - soft tissue"
}, {
"code": "D7230",
"display": "removal of impacted tooth - partially bony"
}, {
"code": "D7240",
"display": "removal of impacted tooth - completely bony"
}, {
"code": "D7241",
"display": "removal of impacted tooth - completely bony, with unusual surgical complications"
}, {
"code": "D7250",
"display": "removal of residual tooth roots (cutting procedure)"
}, {
"code": "D7251",
"display": "coronectomy - intentional partial tooth removal"
} ],
"display": "EXTRACTIONS (INCLUDES LOCAL ANESTHESIA, SUTURING, IF NEEDED, AND ROUTINE POSTOPERATIVE CARE)"
}, {
"code": "D7260-D7297",
"concept": [ {
"code": "D7260",
"display": "oroantral fistula closure"
}, {
"code": "D7261",
"display": "primary closure of a sinus perforation"
}, {
"code": "D7270",
"display": "tooth re-implantation and/or stabilization of accidentally evulsed or displaced tooth"
}, {
"code": "D7272",
"display": "tooth transplantation (includes re-implantation from one site to another and splinting and/or stabilization)"
}, {
"code": "D7280",
"display": "exposure of an unerupted tooth"
}, {
"code": "D7282",
"display": "mobilization of erupted or malpositioned tooth to aid eruption"
}, {
"code": "D7283",
"display": "placement of device to facilitate eruption of impacted tooth"
}, {
"code": "D7285",
"display": "incisional biopsy of oral tissue-hard (bone, tooth)"
}, {
"code": "D7286",
"display": "incisional biopsy of oral tissue-soft"
}, {
"code": "D7287",
"display": "exfoliative cytological sample collection"
}, {
"code": "D7288",
"display": "brush biopsy - transepithelial sample collection"
}, {
"code": "D7290",
"display": "surgical repositioning of teeth"
}, {
"code": "D7291",
"display": "transseptal fiberotomy/supra crestal fiberotomy, by report"
}, {
"code": "D7292",
"display": "placement of temporary anchorage device [screw retained plate] requiring flap; includes device removal"
}, {
"code": "D7293",
"display": "placement of temporary anchorage device requiring flap; includes device removal"
}, {
"code": "D7294",
"display": "placement of temporary anchorage device without flap; includes device removal"
}, {
"code": "D7295",
"display": "harvest of bone for use in autogenous grafting procedure"
}, {
"code": "D7296",
"display": "corticotomy - one to three teeth or tooth spaces, per quadrant"
}, {
"code": "D7297",
"display": "corticotomy - four or more teeth or tooth spaces, per quadrant"
} ],
"display": "OTHER SURGICAL PROCEDURES"
}, {
"code": "D7310-D7321",
"concept": [ {
"code": "D7310",
"display": "alveoloplasty in conjunction with extractions - four or more teeth or tooth spaces, per quadrant"
}, {
"code": "D7311",
"display": "alveoloplasty in conjunction with extractions - one to three teeth or tooth spaces, per quadrant"
}, {
"code": "D7320",
"display": "alveoloplasty not in conjunction with extractions - four or more teeth or tooth spaces, per quadrant"
}, {
"code": "D7321",
"display": "alveoloplasty not in conjunction with extractions - one to three teeth or tooth spaces, per quadrant"
} ],
"display": "ALVEOLOPLASTY - PREPARATION OF RIDGE"
}, {
"code": "D7340-D7350",
"concept": [ {
"code": "D7340",
"display": "vestibuloplasty - ridge extension (secondary epithelialization)"
}, {
"code": "D7350",
"display": "vestibuloplasty - ridge extension (including soft tissue grafts, muscle reattachment, revision of soft tissue attachment and management of hypertrophied and hyperplastic tissue)"
} ],
"display": "VESTIBULOPLASTY"
}, {
"code": "D7410-D7465",
"concept": [ {
"code": "D7410",
"display": "excision of benign lesion up to 1.25 cm"
}, {
"code": "D7411",
"display": "excision of benign lesion greater than 1.25 cm"
}, {
"code": "D7412",
"display": "excision of benign lesion, complicated"
}, {
"code": "D7413",
"display": "excision of malignant lesion up to 1.25 cm"
}, {
"code": "D7414",
"display": "excision of malignant lesion greater than 1.25 cm"
}, {
"code": "D7415",
"display": "excision of malignant lesion, complicated"
}, {
"code": "D7465",
"display": "destruction of lesion(s) by physical or chemical method, by report"
} ],
"display": "EXCISION OF SOFT TISSUE LESIONS"
}, {
"code": "D7440-D7461",
"concept": [ {
"code": "D7440",
"display": "excision of malignant tumor - lesion diameter up to 1.25 cm"
}, {
"code": "D7441",
"display": "excision of malignant tumor - lesion diameter greater than 1.25 cm"
}, {
"code": "D7450",
"display": "removal of benign odontogenic cyst or tumor - lesion diameter up to 1.25 cm"
}, {
"code": "D7451",
"display": "removal of benign odontogenic cyst or tumor - lesion diameter greater than 1.25 cm"
}, {
"code": "D7460",
"display": "removal of benign nonodontogenic cyst or tumor - lesion diameter up to 1.25 cm"
}, {
"code": "D7461",
"display": "removal of benign nonodontogenic cyst or tumor - lesion diameter greater than 1.25 cm"
} ],
"display": "EXCISION OF INTRA-OSSEOUS LESIONS"
}, {
"code": "D7471-D7490",
"concept": [ {
"code": "D7471",
"display": "removal of lateral exostosis (maxilla or mandible)"
}, {
"code": "D7472",
"display": "removal of torus palatinus"
}, {
"code": "D7473",
"display": "removal of torus mandibularis"
}, {
"code": "D7485",
"display": "reduction of osseous tuberosity"
}, {
"code": "D7490",
"display": "radical resection of maxilla or mandible"
} ],
"display": "EXCISION OF BONE TISSUE"
}, {
"code": "D7510-D7560",
"concept": [ {
"code": "D7510",
"display": "incision and drainage of abscess - intraoral soft tissue"
}, {
"code": "D7511",
"display": "incision and drainage of abscess - intraoral soft tissue - complicated (includes drainage of multiple fascial spaces)"
}, {
"code": "D7520",
"display": "incision and drainage of abscess - extraoral soft tissue"
}, {
"code": "D7521",
"display": "incision and drainage of abscess - extraoral soft tissue - complicated (includes drainage of multiple fascial spaces)"
}, {
"code": "D7530",
"display": "removal of foreign body from mucosa, skin, or subcutaneous alveolar tissue"
}, {
"code": "D7540",
"display": "removal of reaction producing foreign bodies, musculoskeletal system"
}, {
"code": "D7550",
"display": "partial ostectomy/sequestrectomy for removal of non-vital bone"
}, {
"code": "D7560",
"display": "maxillary sinusotomy for removal of tooth fragment or foreign body"
} ],
"display": "SURGICAL INCISION"
}, {
"code": "D7610-D7680",
"concept": [ {
"code": "D7610",
"display": "maxilla - open reduction (teeth immobilized, if present)"
}, {
"code": "D7620",
"display": "maxilla - closed reduction (teeth immobilized, if present)"
}, {
"code": "D7630",
"display": "mandible - open reduction (teeth immobilized, if present)"
}, {
"code": "D7640",
"display": "mandible - closed reduction (teeth immobilized, if present)"
}, {
"code": "D7650",
"display": "malar and/or zygomatic arch - open reduction"
}, {
"code": "D7660",
"display": "malar and/or zygomatic arch - closed reduction"
}, {
"code": "D7670",
"display": "alveolus - closed reduction, may include stabilization of teeth"
}, {
"code": "D7671",
"display": "alveolus - open reduction, may include stabilization of teeth"
}, {
"code": "D7680",
"display": "facial bones - complicated reduction with fixation and multiple surgical approaches"
} ],
"display": "TREATMENT OF CLOSED FACTURES"
}, {
"code": "D7710-D7780",
"concept": [ {
"code": "D7710",
"display": "maxilla - open reduction"
}, {
"code": "D7720",
"display": "maxilla - closed reduction"
}, {
"code": "D7730",
"display": "mandible - open reduction"
}, {
"code": "D7740",
"display": "mandible - closed reduction"
}, {
"code": "D7750",
"display": "malar and/or zygomatic arch - open reduction"
}, {
"code": "D7760",
"display": "malar and/or zygomatic arch - closed reduction"
}, {
"code": "D7770",
"display": "alveolus - open reduction stabilization of teeth"
}, {
"code": "D7771",
"display": "alveolus, closed reduction stabilization of teeth"
}, {
"code": "D7780",
"display": "facial bones - complicated reduction with fixation and multiple approaches"
} ],
"display": "TREATMENT OF OPEN FRACTURES"
}, {
"code": "D7810-D7899",
"concept": [ {
"code": "D7810",
"display": "open reduction of dislocation"
}, {
"code": "D7820",
"display": "closed reduction of dislocation"
}, {
"code": "D7830",
"display": "manipulation under anesthesia"
}, {
"code": "D7840",
"display": "condylectomy"
}, {
"code": "D7850",
"display": "surgical discectomy, with/without implant"
}, {
"code": "D7852",
"display": "disc repair"
}, {
"code": "D7854",
"display": "synovectomy"
}, {
"code": "D7856",
"display": "myotomy"
}, {
"code": "D7858",
"display": "joint reconstruction"
}, {
"code": "D7860",
"display": "arthrotomy"
}, {
"code": "D7865",
"display": "arthroplasty"
}, {
"code": "D7870",
"display": "arthrocentesis"
}, {
"code": "D7871",
"display": "non-arthroscopic lysis and lavage"
}, {
"code": "D7872",
"display": "arthroscopy - diagnosis, with or without biopsy"
}, {
"code": "D7873",
"display": "arthroscopy: lavage and lysis of adhesions"
}, {
"code": "D7874",
"display": "arthroscopy: disc repositioning and stabilization"
}, {
"code": "D7875",
"display": "arthroscopy: synovectomy"
}, {
"code": "D7876",
"display": "arthroscopy: discectomy"
}, {
"code": "D7877",
"display": "arthroscopy: debridement"
}, {
"code": "D7880",
"display": "occlusal orthotic device, by report"
}, {
"code": "D7881",
"display": "occlusal orthotic device adjustment"
}, {
"code": "D7899",
"display": "unspecified TMD therapy, by report"
} ],
"display": "REDUCTION OF DISLOCATION AND MANAGEMENT OF OTHER TEMPOROMANDIBULAR JOINT DYSFUNCTIONS"
}, {
"code": "D7910-D7910",
"concept": [ {
"code": "D7910",
"display": "suture of recent small wounds up to 5 cm"
} ],
"display": "REPAIR OF TRAUMATIC WOUNDS"
}, {
"code": "D7911-D7912",
"concept": [ {
"code": "D7911",
"display": "complicated suture - up to 5 cm"
}, {
"code": "D7912",
"display": "complicated suture - greater than 5 cm"
} ],
"display": "COMPLICATED SUTURING (RECONSTRUCTION REQUIRING DELICATE HANDLING OF TISSUES AND WIDE UNDERMINING FOR METICULOUS CLOSURE)"
}, {
"code": "D7920-D7998",
"concept": [ {
"code": "D7920",
"display": "skin graft (identify defect covered, location and type of graft)"
}, {
"code": "D7921",
"display": "collection and application of autologous blood concentrate product"
}, {
"code": "D7922",
"display": "placement of intra-socket biological dressing to aid in hemostasis or clot stabilization, per site"
}, {
"code": "D7940",
"display": "osteoplasty - for orthognathic deformities"
}, {
"code": "D7941",
"display": "osteotomy - mandibular rami"
}, {
"code": "D7943",
"display": "osteotomy - mandibular rami with bone graft; includes obtaining the graft"
}, {
"code": "D7944",
"display": "osteotomy - segmented or subapical"
}, {
"code": "D7945",
"display": "osteotomy - body of mandible"
}, {
"code": "D7946",
"display": "LeFort I (maxilla - total)"
}, {
"code": "D7947",
"display": "LeFort I (maxilla - segmented)"
}, {
"code": "D7948",
"display": "LeFort II or LeFort III (osteoplasty of facial bones for midface hypoplasia or retrusion) - without bone graft"
}, {
"code": "D7949",
"display": "LeFort II or LeFort III - with bone graft"
}, {
"code": "D7950",
"display": "osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla - autogenous or nonautogenous, by report"
}, {
"code": "D7951",
"display": "sinus augmentation with bone or bone substitutes via a lateral open approach"
}, {
"code": "D7952",
"display": "sinus augmentation via a vertical approach"
}, {
"code": "D7953",
"display": "bone replacement graft for ridge preservation - per site"
}, {
"code": "D7955",
"display": "repair of maxillofacial soft and/or hard tissue defect"
}, {
"code": "D7961",
"display": "buccal / labial frenectomy (frenulectomy)"
}, {
"code": "D7962",
"display": "lingual frenectomy (frenulectomy)"
}, {
"code": "D7963",
"display": "frenuloplasty"
}, {
"code": "D7970",
"display": "excision of hyperplastic tissue - per arch"
}, {
"code": "D7971",
"display": "excision of pericoronal gingiva"
}, {
"code": "D7972",
"display": "surgical reduction of fibrous tuberosity"
}, {
"code": "D7979",
"display": "non - surgical sialolithotomy"
}, {
"code": "D7980",
"display": "surgical sialolithotomy"
}, {
"code": "D7981",
"display": "excision of salivary gland, by report"
}, {
"code": "D7982",
"display": "sialodochoplasty"
}, {
"code": "D7983",
"display": "closure of salivary fistula"
}, {
"code": "D7990",
"display": "emergency tracheotomy"
}, {
"code": "D7991",
"display": "coronoidectomy"
}, {
"code": "D7993",
"display": "surgical placement of craniofacial implant - extra oral"
}, {
"code": "D7994",
"display": "surgical placement: zygomatic implant"
}, {
"code": "D7995",
"display": "synthetic graft - mandible or facial bones, by report"
}, {
"code": "D7996",
"display": "implant-mandible for augmentation purposes (excluding alveolar ridge), by report"
}, {
"code": "D7997",
"display": "appliance removal (not by dentist who placed appliance), includes removal of archbar"
}, {
"code": "D7998",
"display": "intraoral placement of a fixation device not in conjunction with a fracture"
} ],
"display": "OTHER REPAIR PROCEDURES"
}, {
"code": "D7999",
"display": "unspecified oral surgery procedure, by report"
} ],
"display": "ORAL & MAXILLOFACIAL SURGERY"
}, {
"code": "D8010-D8999",
"concept": [ {
"code": "D8010-D8040",
"concept": [ {
"code": "D8010",
"display": "limited orthodontic treatment of the primary dentition"
}, {
"code": "D8020",
"display": "limited orthodontic treatment of the transitional dentition"
}, {
"code": "D8030",
"display": "limited orthodontic treatment of the adolescent dentition"
}, {
"code": "D8040",
"display": "limited orthodontic treatment of the adult dentition"
} ],
"display": "LIMITED ORTHODONTIC TREATMENT"
}, {
"code": "D8050-D8060",
"concept": [ {
"code": "D8050",
"display": "interceptive orthodontic treatment of the primary dentition"
}, {
"code": "D8060",
"display": "interceptive orthodontic treatment of the transitional dentition"
} ],
"display": "INTERCEPTIVE ORTHODONTIC TREATMENT"
}, {
"code": "D8070-D8090",
"concept": [ {
"code": "D8070",
"display": "comprehensive orthodontic treatment of the transitional dentition"
}, {
"code": "D8080",
"display": "comprehensive orthodontic treatment of the adolescent dentition"
}, {
"code": "D8090",
"display": "comprehensive orthodontic treatment of the adult dentition"
} ],
"display": "COMPREHENSIVE ORTHODONTIC TREATMENT"
}, {
"code": "D8210-D8220",
"concept": [ {
"code": "D8210",
"display": "removable appliance therapy"
}, {
"code": "D8220",
"display": "fixed appliance therapy"
} ],
"display": "MINOR TREATMENT TO CONTROL HARMFUL HABITS"
}, {
"code": "D8660-D8999",
"concept": [ {
"code": "D8660",
"display": "pre-orthodontic treatment examination to monitor growth and development"
}, {
"code": "D8670",
"display": "periodic orthodontic treatment visit"
}, {
"code": "D8680",
"display": "orthodontic retention (removal of appliances, construction and placement of retainer(s))"
}, {
"code": "D8681",
"display": "removable orthodontic retainer adjustment"
}, {
"code": "D8690",
"display": "orthodontic treatment (alternative billing to a contract fee)"
}, {
"code": "D8695",
"display": "removal of fixed orthodontic appliances for reasons other than completion of treatment"
}, {
"code": "D8696",
"display": "repair of orthodontic appliance - maxillary"
}, {
"code": "D8697",
"display": "repair of orthodontic appliance - mandibular"
}, {
"code": "D8698",
"display": "re-cement or re-bond fixed retainer - maxillary"
}, {
"code": "D8699",
"display": "re-cement or re-bond fixed retainer - mandibular"
}, {
"code": "D8701",
"display": "repair of fixed retainer, includes reattachment - maxillary"
}, {
"code": "D8702",
"display": "repair of fixed retainer, includes reattachment - mandibular"
}, {
"code": "D8703",
"display": "replacement of lost or broken retainer - maxillary"
}, {
"code": "D8704",
"display": "replacement of lost or broken retainer - mandibular"
}, {
"code": "D8999",
"display": "unspecified orthodontic procedure, by report"
} ],
"display": "OTHER ORTHODONTIC SERVICES"
} ],
"display": "ORTHODONTICS"
}, {
"code": "D9110-D9999",
"concept": [ {
"code": "D9110-D9130",
"concept": [ {
"code": "D9110",
"display": "palliative (emergency) treatment of dental pain - minor procedure"
}, {
"code": "D9120",
"display": "fixed partial denture sectioning"
}, {
"code": "D9130",
"display": "temporomandibular joint dysfunction - non-invasive physical therapies"
} ],
"display": "UNCLASSIFIED TREATMENT"
}, {
"code": "D9210-D9248",
"concept": [ {
"code": "D9210",
"display": "local anesthesia not in conjunction with operative or surgical procedures"
}, {
"code": "D9211",
"display": "regional block anesthesia"
}, {
"code": "D9212",
"display": "trigeminal division block anesthesia"
}, {
"code": "D9215",
"display": "local anesthesia in conjunction with operative or surgical procedures"
}, {
"code": "D9219",
"display": "evaluation for moderate sedation, deep sedation or general anesthesia"
}, {
"code": "D9222",
"display": "deep sedation/general anesthesia - first 15 minutes"
}, {
"code": "D9223",
"display": "deep sedation/general anesthesia - each subsequent 15 minute increment"
}, {
"code": "D9230",
"display": "inhalation of nitrous oxide/analgesia, anxiolysis"
}, {
"code": "D9239",
"display": "intravenous moderate (conscious) sedation/analgesia- first 15 minutes"
}, {
"code": "D9243",
"display": "intravenous moderate (conscious) sedation/analgesia - each subsequent 15 minute increment"
}, {
"code": "D9248",
"display": "non-intravenous conscious sedation"
} ],
"display": "ANESTHESIA"
}, {
"code": "D9310-D9311",
"concept": [ {
"code": "D9310",
"display": "consultation - diagnostic service provided by dentist or physician other than requesting dentist or physician"
}, {
"code": "D9311",
"display": "consultation with a medical health care professional"
} ],
"display": "PROFESSIONAL CONSULTATION"
}, {
"code": "D9410-D9450",
"concept": [ {
"code": "D9410",
"display": "house/extended care facility call"
}, {
"code": "D9420",
"display": "hospital or ambulatory surgical center call"
}, {
"code": "D9430",
"display": "office visit for observation (during regularly scheduled hours) - no other services performed"
}, {
"code": "D9440",
"display": "office visit - after regularly scheduled hours"
}, {
"code": "D9450",
"display": "case presentation, detailed and extensive treatment planning"
} ],
"display": "PROFESSIONAL VISITS"
}, {
"code": "D9610-D9630",
"concept": [ {
"code": "D9610",
"display": "therapeutic parenteral drug, single administration"
}, {
"code": "D9612",
"display": "therapeutic parenteral drugs, two or more administrations, different medications"
}, {
"code": "D9613",
"display": "infiltration of sustained release therapeutic drug - single or multiple sites"
}, {
"code": "D9630",
"display": "drugs or medicaments dispensed in the office for home use"
} ],
"display": "DRUGS"
}, {
"code": "D9910-D9975",
"concept": [ {
"code": "D9910",
"display": "application of desensitizing medicament"
}, {
"code": "D9911",
"display": "application of desensitizing resin for cervical and/or root surface, per tooth"
}, {
"code": "D9920",
"display": "behavior management, by report"
}, {
"code": "D9930",
"display": "treatment of complications (post-surgical) - unusual circumstances, by report"
}, {
"code": "D9932",
"display": "cleaning and inspection of removable complete denture, maxillary"
}, {
"code": "D9933",
"display": "cleaning and inspection of removable complete denture, mandibular"
}, {
"code": "D9934",
"display": "cleaning and inspection of removable partial denture, maxillary"
}, {
"code": "D9935",
"display": "cleaning and inspection of removable partial denture, mandibular"
}, {
"code": "D9941",
"display": "fabrication of athletic mouthguard"
}, {
"code": "D9942",
"display": "repair and/or reline of occlusal guard"
}, {
"code": "D9943",
"display": "occlusal guard adjustment"
}, {
"code": "D9944",
"display": "occlusal guard - hard appliance, full arch"
}, {
"code": "D9945",
"display": "occlusal guard - soft appliance, full arch"
}, {
"code": "D9946",
"display": "occlusal guard - hard appliance, partial arch"
}, {
"code": "D9950",
"display": "occlusion analysis - mounted case"
}, {
"code": "D9951",
"display": "occlusal adjustment - limited"
}, {
"code": "D9952",
"display": "occlusal adjustment - complete"
}, {
"code": "D9970",
"display": "enamel microabrasion"
}, {
"code": "D9971",
"display": "odontoplasty - per tooth"
}, {
"code": "D9972",
"display": "external bleaching - per arch - performed in office"
}, {
"code": "D9973",
"display": "external bleaching - per tooth"
}, {
"code": "D9974",
"display": "internal bleaching - per tooth"
}, {
"code": "D9975",
"display": "external bleaching for home application, per arch; includes materials and fabrication of custom trays"
} ],
"display": "MISCELLANEOUS SERVICES"
}, {
"code": "D9961-D9997",
"concept": [ {
"code": "D9961",
"display": "duplicate/copy patient's records"
}, {
"code": "D9985",
"display": "sales tax"
}, {
"code": "D9986",
"display": "missed appointment"
}, {
"code": "D9987",
"display": "cancelled appointment"
}, {
"code": "D9990",
"display": "certified translation or sign-language services - per visit"
}, {
"code": "D9991",
"display": "dental case management - addressing appointment compliance barriers"
}, {
"code": "D9992",
"display": "dental case management - care coordination"
}, {
"code": "D9993",
"display": "dental case management - motivational interviewing"
}, {
"code": "D9994",
"display": "dental case management - patient education to improve oral health literacy"
}, {
"code": "D9995",
"display": "teledentistry - synchronous; real-time encounter"
}, {
"code": "D9996",
"display": "teledentistry - asynchronous; information stored and forwarded to dentist for subsequent review"
}, {
"code": "D9997",
"display": "dental case management - patients with special health care needs"
} ],
"display": "NON-CLINICAL PROCEDURES"
}, {
"code": "D9999",
"display": "unspecified adjunctive procedure, by report"
} ],
"display": "ADJUNCTIVE GENERAL SERVICES"
} ],
"display": "CDT"
} ],
"version": "1.1"
}