Most common D0464 code reviews : , Non-ionizing diagnostic procedure capable of quantifying, monitoring and recording changes in structure of enamel, dentin and cementum or Intravenous moderate (conscious) sedation analgesia - 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.
Most often D0464 related to the diagnosis of an infection, which may be covered by a patient`s medical insurance the dental office may want to confirm which plan offers the best benefits to the patient).
A patient presents to your office with a buccal space abscess in the upper left quadrant eliminating the nasolabial fold The tooth has no history of previous trauma Clinical evaluation reveals a large resin with recurrent caries Endodontic testing is performed and tooth #10 is necrotic and severely responsive to percussion A periapical radiograph is taken and a 4mm x 5mm periapical lesion of endodontic origin is visualized. Palpation reveals a fluctuant buccal swelling centered apically to tooth #10. Incision and drainage performed with a drain sutured into place Endodontic treatment or retreatment can be initiated and calcium hydroxide placed Any additional treatments should be coded appropriately.
Indirectly fabricated post and core in addition to crown is Benefited only on a completed endodontically treated tooth. **An indirectly fabricated post and core for an anterior tooth is Benefited only when there is insufficient tooth structure to support an indirectly fabricated restoration due to loss of actual tooth structure from caries or fracture. If sufficient tooth structure remains, the fee for the post and core is Disallowed.
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