SBS Code
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| Chapter
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⌀ | Definition
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⌀ | Guidelines
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|---|---|---|---|---|---|---|---|---|---|---|---|
972810000
|
97281-00-00
|
Non surg periodontal treatment, NEC
|
Nonsurgical periodontal treatment, not elsewhere classified
| 6
|
Dental services
| 456
|
Periodontic interventions
| null |
Application of medicaments, debridement, lavage
|
Removal of gingival calculus and plaque (97114-00-00 [453]), that with any other periodontal procedure – omit code
| null |
972810010
|
97281-00-10
|
Gen scaling & root planning; severe plaque & calculus deposition 1st appt
|
Generalized scaling and root planning; severe plaque and calculus deposition, first appointment
| 6
|
Dental services
| 456
|
Periodontic interventions
|
the removal of plaque, calculus and stains from supra and subgingival tooth surfaces.
|
Application of medicaments, debridement, lavage
|
Removal of gingival calculus and plaque (97114-00-00 [453]), that with any other periodontal procedure – omit code
| null |
972810020
|
97281-00-20
|
Gingival irrigation
|
Gingival irrigation
| 6
|
Dental services
| 456
|
Periodontic interventions
|
Flushing out plaque, bacteria and other toxins trapped in the small spaces between teeth and under the gumline, preventing the build-up of harmful bacteria.
|
Application of medicaments, debridement, lavage
|
Removal of gingival calculus and plaque (97114-00-00 [453]), that with any other periodontal procedure – omit code
| null |
972810030
|
97281-00-30
|
Custom-made trays vesiculobullous disease
|
Custom-made trays for vesiculobullous disease
| 6
|
Dental services
| 456
|
Periodontic interventions
| null |
Application of medicaments, debridement, lavage
|
Removal of gingival calculus and plaque (97114-00-00 [453]), that with any other periodontal procedure – omit code
| null |
972810040
|
97281-00-40
|
Custom-made trays periodontal disease
|
Custom-made trays for periodontal disease
| 6
|
Dental services
| 456
|
Periodontic interventions
| null |
Application of medicaments, debridement, lavage
|
Removal of gingival calculus and plaque (97114-00-00 [453]), that with any other periodontal procedure – omit code
| null |
972810050
|
97281-00-50
|
Admin antimicrobial agents; localized delivery
|
Administration of antimicrobial agents; localized delivery
| 6
|
Dental services
| 456
|
Periodontic interventions
| null |
Application of medicaments, debridement, lavage
|
Removal of gingival calculus and plaque (97114-00-00 [453]), that with any other periodontal procedure – omit code
| null |
972810060
|
97281-00-60
|
Scal & debrid inflamm/mucosi implnt w/o flap entry & clos
|
Scaling and debridement in the presence of inflammation or mucositis of an implant, including cleaning of the implant surfaces, without flap entry and closure; per implant
| 6
|
Dental services
| 456
|
Periodontic interventions
| null |
Application of medicaments, debridement, lavage
|
Removal of gingival calculus and plaque (97114-00-00 [453]), that with any other periodontal procedure – omit code
| null |
972810070
|
97281-00-70
|
Peri-implant debridement & osseous contouring proc
|
Peri-implant debridement and osseous contouring procedure of defects surrounding a single implant, including flap entry and closure
| 6
|
Dental services
| 456
|
Periodontic interventions
| null |
Flap entry and closure
| null | null |
972130000
|
97213-00-00
|
Treatment acute periodontal infection
|
Treatment of acute periodontal infection
| 6
|
Dental services
| 456
|
Periodontic interventions
|
the treatment of acute periodontal infection(s). It may include establishing drainage and the removal of calculus from the affected tooth (teeth) or implant.
|
Drainage of abscess by incision, lavage, prescription of antibiotics, removal of debris and deposits from gums and gingival crevice
| null | null |
972220000
|
97222-00-00
|
Root planning subgingvl curet <= 8 teeth
|
Root planning with subgingival curettage<= 8 teeth
| 6
|
Dental services
| 456
|
Periodontic interventions
| null |
Removal of calculus, plaque
| null | null |
972310000
|
97231-00-00
|
Gingivectomy <= 8 teeth
|
Gingivectomy, up to 8 teeth
| 6
|
Dental services
| 456
|
Periodontic interventions
|
the surgical removal of the soft tissue wall of the periodontal pocket or the removal of swollen, excess gingival tissue.
|
Planning of root, removal of calculus, periodontal debridement of the teeth.
| null | null |
972310100
|
97231-01-00
|
Gingivectomy > 8 teeth
|
Gingivectomy more than 8 teeth
| 6
|
Dental services
| 456
|
Periodontic interventions
|
the surgical removal of the soft tissue wall of the periodontal pocket or the removal of swollen, excess gingival tissue.
|
Planning of root, removal of calculus, periodontal debridement of the teeth.
| null | null |
972310200
|
97231-02-00
|
Gingivectomy for restorative proc
|
Gingivectomy for restorative procedure, per tooth
| 6
|
Dental services
| 456
|
Periodontic interventions
|
the surgical removal of the soft tissue wall of the periodontal pocket or the removal of swollen, excess gingival tissue to access and restore suprabony pockets (pockets that are coronal to the bone level).
| null | null | null |
972340000
|
97234-00-00
|
Alveolar osseous grft / implant per tth
|
Alveolar osseous graft, per tooth or implant
| 6
|
Dental services
| 456
|
Periodontic interventions
|
A surgical procedure in which particulate bone, a synthetic substitute or other matrix is used to replace, repair or augment alveolar bone. It may be used to repair a bony defect around a tooth or dental implant.
|
Planning of root, removal of calculus, repair of alveolar bone replacement
| null | null |
972351000
|
97235-10-00
|
Auto connec tiss grft implt/endent tooth area grft site; donor
|
Auto connective tissue graft, implant or edentulous tooth area in graft site - donor site
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972352000
|
97235-20-00
|
Auto conn tiss grft implt/endent tooth area grft site; recipnt
|
Auto connective tissue graft, implant or edentulous tooth area in graft site - recipient site
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972353500
|
97235-35-00
|
Connective tissue & double pedicle graft combined proc
|
Connective tissue & double pedicle graft, combined procedure
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972354010
|
97235-40-10
|
Non-auto con tiss grft implt/endent tooth area grft site; donor
|
Non-autogenous connective tissue graft each tooth, implant or edentulous tooth area in graft site; donor site
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972354020
|
97235-40-20
|
Non-auto con tiss grft implt/endent tooth area grft site; recipnt
|
Non-autogenous connective tissue graft each tooth, implant or edentulous tooth area in graft site; recipient site
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972355010
|
97235-50-10
|
Free sft tiss grft ea tooth implnt/endent tooth area grft site; donor
|
Free soft tissue graft each tooth, implant or edentulous tooth area in graft site; donor site
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972355020
|
97235-50-20
|
Free sft tiss grft ea tooth implnt/endent tooth area grft site; recipnt
|
Free soft tissue graft each tooth, implant or edentulous tooth area in graft site; recipient site
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972360000
|
97236-00-00
|
Guided tis regenertn per tooth/implant
|
Guided tissue regeneration, per tooth or implant
| 6
|
Dental services
| 456
|
Periodontic interventions
|
A surgical technique in which a membrane is adapted over a bony defect, the tooth root or an implant.
| null | null | null |
972380000
|
97238-00-00
|
Periodontal flap proc crown lengthening
|
Periodontal flap procedure for crown lengthening, per tooth
| 6
|
Dental services
| 456
|
Periodontic interventions
| null |
Reshaping of alveolar bone
| null | null |
972430000
|
97243-00-00
|
Bone replace graft for ridge preservation per site
|
Bone replacement graft for ridge preservation - per site
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972510010
|
97251-00-10
|
Periodontal therapy; supportive tx per appt
|
Periodontal therapy (supportive treatment), per appointment
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972600100
|
97260-01-00
|
Admin biolog mat sft & osseous tiss gnrtion w periradicular surg
|
Administration of biologic materials to aid in soft and osseous tissue regeneration with periradicular surgery, per tooth
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972600200
|
97260-02-00
|
Peri-implant disease treatment; surg per implant
|
Surgical treatment of peri-implant disease; per implant
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972600310
|
97260-03-10
|
Anatomical crown exposure per arch
|
Anatomical crown exposure, per arch
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972600400
|
97260-04-00
|
Wedge proc mesial & distal
|
Wedge procedure, mesial and distal, per tooth
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972600510
|
97260-05-10
|
Recontour tissue; per appt
|
Recontour tissue; per appointment
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972700010
|
97270-00-10
|
Transposition flap (small)
|
Transposition flap (small)
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972700110
|
97270-01-10
|
Transposition flap (moderate)
|
Transposition flap (moderate)
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972700120
|
97270-01-20
|
Rotation flap (moderate)
|
Rotation flap (moderate)
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972710000
|
97271-00-00
|
Apically positioned perio flap
|
Apically positioned periodontal flap
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972710100
|
97271-01-00
|
Open flap/ curettage surgery
|
Open flap/ curettage surgery; per tooth/ implant
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972710200
|
97271-02-00
|
Pedicle soft tissue graft
|
Pedicle soft tissue graft
| 6
|
Dental services
| 456
|
Periodontic interventions
| null | null | null | null |
972450000
|
97245-00-00
|
Surg periodontal proc tooth or impl, NEC
|
Surgical periodontal procedure, not elsewhere classified
| 6
|
Dental services
| 456
|
Periodontic interventions
|
Cautery for endodontic access, Gingivoplasty, Pericision
| null | null | null |
973110100
|
97311-01-00
|
R/O 1 tooth or part(s) thereof
|
Simple removal (extraction) of tooth or part(s) thereof
| 6
|
Dental services
| 457
|
Nonsurgical removal of tooth
| null | null |
That as part of full dental clearance, Upper 97322-09-00 and Lower 97322-10-00
|
Do not bill with 97314-01-10, 97321-03-00, 97322-00-10, 97321-01-00, 97321-02-00, 97324-01-00, 97321-04-00
|
973140100
|
97314-01-00
|
Sectional R/O 1 tooth / part(s) thereof
|
Sectional removal of one tooth or part(s) thereof
| 6
|
Dental services
| 457
|
Nonsurgical removal of tooth
| null | null |
That as part of full dental clearance, Upper 97322-09-00 and Lower 97322-10-00
|
Do not bill with 97321-04-00, 97321-03-00, 97322-00-10, 97321-01-00, 97321-02-00, 97324-01-00, 97321-04-00
|
980020000
|
98002-00-00
|
Rmvl of primary tooth/ part(s) thereof
|
Removal (extraction) of primary tooth or part(s) thereof
| 6
|
Dental services
| 457
|
Nonsurgical removal of tooth
| null | null | null |
A dentist could extract the whole tooth, tooth root, or the retained crown in the primary dentition.
|
973210100
|
97321-01-00
|
Surg rmvl impacted tooth partial bony impaction
|
Surgical removal of impacted tooth; partial bony impaction; per tooth
| 6
|
Dental services
| 458
|
Surgical removal of tooth
| null | null |
That as part of full dental clearance, Upper 97322-09-00 and Lower 97322-10-00
|
Do not bill with 97311-01-10
|
973210200
|
97321-02-00
|
Surg rmvl impacted tooth complete bony impaction
|
Surgical removal of impacted tooth; complete bony impaction; per tooth
| 6
|
Dental services
| 458
|
Surgical removal of tooth
| null | null |
That as part of full dental clearance, Upper 97322-09-00 and Lower 97322-10-00
|
Do not bill with 97311-01-10
|
973210400
|
97321-04-00
|
Surg rmvl remaining root
|
Surgical removal of remaining root; per root
| 6
|
Dental services
| 458
|
Surgical removal of tooth
| null | null |
That as part of full dental clearance, Upper 97322-09-00 and Lower 97322-10-00
|
Do not bill with 97314-01-10
|
973210500
|
97321-05-00
|
Surg rmvl one tooth; soft tissue
|
Surgical removal of one tooth; soft tissue (not requiring removal of bone or tooth division)
| 6
|
Dental services
| 458
|
Surgical removal of tooth
| null | null |
That as part of full dental clearance, Upper 97322-09-00 and Lower 97322-10-00
|
Do not bill with 97311-01-10
|
973210600
|
97321-06-00
|
Coronectomy
|
Coronectomy; per tooth
| 6
|
Dental services
| 458
|
Surgical removal of tooth
|
Removal of the crown of a tooth while leaving a part of the roots in place
| null | null | null |
973210710
|
97321-07-10
|
Corticotomy < = 3 teeth/ edentulous spaces
|
Corticotomy less than or equal to 3 teeth or edentulous spaces
| 6
|
Dental services
| 458
|
Surgical removal of tooth
| null | null | null | null |
973210720
|
97321-07-20
|
Corticotomy > 3 teeth/ edentulous spaces
|
Corticotomy more than 3 teeth or edentulous spaces
| 6
|
Dental services
| 458
|
Surgical removal of tooth
| null | null | null | null |
973220900
|
97322-09-00
|
Full upper dental clearance
|
Full upper dental clearance
| 6
|
Dental services
| 458
|
Surgical removal of tooth
|
Removal of all remaining teeth in upper jaw only
|
Surgical or nonsurgical removal
| null |
If a full dental clearance of upper and lower teeth was performed, both 97322-09-00 and 97322-10-00 are assigned
|
973221000
|
97322-10-00
|
Full lower dental clearance
|
Full lower dental clearance
| 6
|
Dental services
| 458
|
Surgical removal of tooth
|
Removal of all remaining teeth in lower jaw only
|
Surgical or nonsurgical removal
| null |
If a full dental clearance of upper and lower teeth was performed, both 97322-09-00 and 97322-10-00 are assigned
|
973240100
|
97324-01-00
|
Surg R/O 1 tooth w R/O bone / div
|
Surgical removal of one tooth requiring both removal of bone and tooth division (includes elevation of mucoperiosteal flap)
| 6
|
Dental services
| 458
|
Surgical removal of tooth
| null | null |
That as part of full dental clearance, Upper 97322-09-00 and Lower 97322-10-00
|
Do not bill with 97311-01-10
|
973310010
|
97331-00-10
|
Alveoloplasty for 1-3 missing teeth spaces
|
Alveoloplasty for one to three missing teeth spaces
| 6
|
Dental services
| 459
|
Surgery for prosthetics
|
Surgical recontouring of supporting bone for one to three missing teeth spaces
| null | null | null |
973310020
|
97331-00-20
|
Alveoloplasty for 4 or more missing teeth spaces
|
Alveoloplasty for four or more missing teeth spaces
| 6
|
Dental services
| 459
|
Surgery for prosthetics
|
Surgical recontouring of supporting bone for four or more missing teeth spaces
| null | null | null |
973350010
|
97335-00-10
|
Ridge split surg proc
|
Ridge split surgical procedure
| 6
|
Dental services
| 459
|
Surgery for prosthetics
| null | null | null | null |
973380000
|
97338-00-00
|
Reduction flabby ridge per segment
|
Reduction of flabby ridge, per segment
| 6
|
Dental services
| 459
|
Surgery for prosthetics
| null | null | null | null |
973410000
|
97341-00-00
|
R/O hyperplastic tissue
|
Removal of hyperplastic tissue; per tooth
| 6
|
Dental services
| 459
|
Surgery for prosthetics
|
Removal of hyperplastic tissue from maxillary or mandibular alveolar ridge or adjacent mucosa
| null | null | null |
973430000
|
97343-00-00
|
Repositioning oral muscle attachment
|
Repositioning of oral muscle attachment
| 6
|
Dental services
| 459
|
Surgery for prosthetics
| null | null | null | null |
973770000
|
97377-00-00
|
Dental tx inv rmvl or rep soft tissue nec
|
Dental treatment involving removal or repair of soft tissue, not elsewhere classified
| 6
|
Dental services
| 460
|
General surgical dental procedure
|
Used for dental treatment involving removal or repair of soft tissue that is not adequately described by a code
|
Fibreotomy, Other repair of skin and subcutaneous tissue of Oral cavity
| null | null |
973770020
|
97377-00-20
|
Rmvl pericoronal gingiva
|
Removal of pericoronal gingiva
| 6
|
Dental services
| 460
|
General surgical dental procedure
| null | null | null |
Surgical removal of inflammatory or hypertrophied tissues surrounding partially erupted/impacted teeth
|
973790000
|
97379-00-00
|
Marsupialisation of cyst in oral cavity
|
Marsupialisation of cyst in oral cavity
| 6
|
Dental services
| 460
|
General surgical dental procedure
| null | null |
That of salivary duct or gland (30266-02-10, 30266-02-00 [395])
| null |
973810000
|
97381-00-00
|
Surg exposure of impacted tooth
|
Surgical exposure of impacted (unerupted) tooth with stimulation and packing
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null | null | null | null |
973820000
|
97382-00-00
|
Surg exp unerptd tooth w orthdntc tractn
|
Surgical exposure of impacted (unerupted) tooth and placement of an orthodontic appliance
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null |
placement of an orthodontic appliance
|
Applications of orthodontic force to malpositioned, erupted teeth: bonding of attachment (97862-00-00 [482])
| null |
973840000
|
97384-00-00
|
Repositioning displaced tooth per tooth
|
Repositioning of displaced tooth; per tooth
| 6
|
Dental services
| 461
|
Other dental surgical procedure
|
Repositioning of displaced tooth by manipulation
| null |
Surgical repositioning of unerupted tooth (97385-00-10 [461])
|
Code also when performed: stabilising procedures: replantation and splinting (97387-00-10 [461]), splinting (97386-01-10 [461])
|
973850000
|
97385-00-00
|
Surgical repositioning unerupted tooth
|
Surgical repositioning of unerupted tooth
| 6
|
Dental services
| 461
|
Other dental surgical procedure
|
Surgical exposure and manipulation of unerupted tooth
| null | null |
Repositioning (manipulation) of tooth (97384-00-10 [461])
|
973860100
|
97386-01-00
|
Splinting of displaced tooth per tooth
|
Splinting of displaced tooth; per tooth
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null | null | null |
Code also when performed: Repositioning (manipulation) of tooth (97384-00-10 [461])
|
973870000
|
97387-00-00
|
Replantation and splinting of tooth
|
Reimplantation and splinting of tooth; per tooth
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null | null | null |
Code also when performed: provision of splint: metal (97773-00-00 [477]), resin (97772-00-00 [477])
|
973871010
|
97387-10-10
|
Implant supported oral surg splint
|
Implant supported oral surgical splint
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null | null | null | null |
973880000
|
97388-00-00
|
Transplantation of tooth or tooth bud
|
Transplantation of tooth or tooth bud; per tooth or bud
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null |
Reimplantation from one site to another and splinting and/or stabilization
| null | null |
973890100
|
97389-01-00
|
Surg to isolate & preserve neurovasc tis
|
Surgery to isolate and preserve neurovascular tissue
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null | null | null | null |
973950000
|
97395-00-00
|
Suture nrv trunk in conjtn w dental proc
|
Suture of nerve trunk in conjunction with dental procedure; per nerve trunk
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null | null | null | null |
973990000
|
97399-00-00
|
Cntl postop haem fol dental proc
|
Control of postoperative haemorrhage following dental procedure; per visit
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null |
Insertion of oral suture
|
Insertion of oral suture for any other dental procedure – omit code
| null |
973990010
|
97399-00-10
|
Unlist oral surgery proc
|
Unlisted oral surgery procedure
| 6
|
Dental services
| 461
|
Other dental surgical procedure
| null | null | null |
Used to identify dental procedures which are not described by any other codes. Adequate written description of the service is required.
|
974110000
|
97411-00-00
|
Direct pulp capping
|
Direct pulp capping
| 6
|
Dental services
| 462
|
Pulp treatment
|
A method for treating exposed vital pulp with dental material to facilitate the formation of reparative dentin and to maintain pulp vitality.
| null | null |
Code also when performed: any restorative dental procedure (see blocks [465], [466] and [469])
|
974110100
|
97411-01-00
|
Indirect pulp capping
|
Indirect pulp capping
| 6
|
Dental services
| 462
|
Pulp treatment
|
A method for treating carious lesion that approaches the pulp tissue, but a pulp exposure does not occur with dental material to facilitate the formation of reparative dentin and to maintain pulp vitality.
| null | null |
Code also when performed: any restorative dental procedure (see blocks [465], [466] and [469])
|
974140000
|
97414-00-00
|
Pulpotomy
|
Pulpotomy for immature permanent, primary dentition
| 6
|
Dental services
| 462
|
Pulp treatment
|
Amputation within the pulp chamber of part of the vital pulp of a tooth. the pulp remaining in the canal(s) is then covered with a protective dressing or cement.
| null | null | null |
974140100
|
97414-01-00
|
Partial pulpotomy permanent
|
Partial pulpotomy permanent tooth
| 6
|
Dental services
| 462
|
Pulp treatment
|
Removal of pulp chamber of vital pulp of a tooth. the pulp remaining in the canal(s) is then covered with a protective dressing or cement.
| null | null |
Code also when performed: any restorative dental procedure (see blocks [465], [466] and [469])
|
974140200
|
97414-02-00
|
Apexogenesis
|
Apexogenesis
| 6
|
Dental services
| 462
|
Pulp treatment
| null | null | null | null |
974140300
|
97414-03-00
|
Apexification/ recalcification; initial visit
|
Apexification/ recalcification; initial visit
| 6
|
Dental services
| 462
|
Pulp treatment
|
A method of treatment for immature permanent teeth in which root growth and development ceased due to pulp necrosis (lost pulp vitality), Initial Visit.
| null | null | null |
974140400
|
97414-04-00
|
Apexification/ recalcification medication replace visit
|
Apexification/ recalcification, medication replacement visit
| 6
|
Dental services
| 462
|
Pulp treatment
|
A method of treatment for immature permanent teeth in which root growth and development ceased due to pulp necrosis (lost pulp vitality), medication replacement visit.
| null | null | null |
974140500
|
97414-05-00
|
Pulpal regeneration
|
Pulpal regeneration; each visit; per tooth
| 6
|
Dental services
| 462
|
Pulp treatment
|
A procedure, likely to include multiple appointments, with the intention is to sterilize a root canal space, then encourage vital tissue to grow back into that canal space in an attempt to strengthen a weak tooth and regain vital tissue in the pulp canal space.
| null | null | null |
974150000
|
97415-00-00
|
Chemomech prep root canal 1 canal
|
Complete chemomechanical preparation of root canal
| 6
|
Dental services
| 462
|
Pulp treatment
|
Including removal of pulp or necrotic debris from a canal.
|
Removal of pulp or necrotic debris from canal
| null |
When performed by another dentist other than the one who extirpated the pulp; Do not bill along with 97420-01-00, 97420-02-00, 97420-03-00
|
974160000
|
97416-00-00
|
Chemomech prep root canal each add canal
|
Complete chemomechanical preparation of root canal; any additional canal (beyond the usual number of roots per tooth) (add on code)
| 6
|
Dental services
| 462
|
Pulp treatment
|
Including removal of pulp or necrotic debris from each additional canal of a tooth with multiple canals.
|
Removal of pulp or necrotic debris from canal
| null |
Beyond the usual number of roots per tooth (add on code); to be billed as add on code with 97420-01-00, 97420-02-00, 97420-03-00, 97415-00-10
Code first: chemomechanical preparation of 1 root canal (97415-00-10 [462])
|
974170000
|
97417-00-00
|
Root canal obturation 1 canal
|
Root canal obturation
| 6
|
Dental services
| 462
|
Pulp treatment
|
Filling of root canal following chemomechanical preparation
| null | null |
When performed by another dentist other than the one who extirpated the pulp or chemomechanically prepared the root; Do not bill along with 97420-01-00, 97420-02-00, 97420-03-00
|
974180000
|
97418-00-00
|
Root canal obturation each add canal
|
Root canal obturation; any additional canal (beyond the usual number of roots per tooth) (add on code)
| 6
|
Dental services
| 462
|
Pulp treatment
|
Filling, following chemomechanical preparation, of each additional canal in a tooth with multiple canals
| null | null |
Beyond the usual number of roots per tooth (add on code); to be billed as add on code with 97420-01-00, 97420-02-00, 97420-03-00, 97417-00-10
Code first: 1 root canal obturation (97417-00-10 [462])
|
974190000
|
97419-00-00
|
Extrp pulp/dbrd root cnl emerg/pltv proc
|
Extirpation of pulp or debridement of root canal(s), emergency or palliative procedure
| 6
|
Dental services
| 462
|
Pulp treatment
|
Emergency or palliative procedure to remove pulp and debris from root canal system
|
Closure of access cavity
|
Non-emergency or nonpalliative removal of pulp and debris (97415-00-10, 97416-00-10 [462])
|
Do not bill along with 97420-01-00, 97420-02-00, 97420-03-00
|
974191000
|
97419-10-00
|
Extirpation of pulp/ debridement root canal(s) additional root canal
|
Extirpation of pulp or debridement of root canal(s), emergency or palliative procedure for any additional root canal (beyond the usual number of roots per tooth), add on code
| 6
|
Dental services
| 462
|
Pulp treatment
|
Emergency or palliative procedure to remove pulp and debris from root canal system for each additional canal of a tooth with multiple canals.
| null | null |
to be billed as add on code with 97420-01-00, 97420-02-00, 97420-03-00, 97419-00-10
|
974200100
|
97420-01-00
|
Root canal treatment anterior
|
Root canal treatment, anterior (includes extirpation of pulp, chemomechanical preparation, obturation)
| 6
|
Dental services
| 462
|
Pulp treatment
| null |
Extirpation of pulp, chemomechanical preparation, obturation.
| null |
Do not bill along with 97415-00-10, 97417-00-10, 97419-00-10
|
974200200
|
97420-02-00
|
Root canal treatment premolar
|
Root canal treatment, premolar (includes extirpation of pulp, chemomechanical preparation, obturation)
| 6
|
Dental services
| 462
|
Pulp treatment
| null |
Extirpation of pulp, chemomechanical preparation, obturation.
| null |
Do not bill along with 97415-00-10, 97417-00-10, 97419-00-10
|
974200300
|
97420-03-00
|
Root canal treatment molar
|
Root canal treatment, molar (includes extirpation of pulp, chemomechanical preparation, obturation)
| 6
|
Dental services
| 462
|
Pulp treatment
| null |
Extirpation of pulp, chemomechanical preparation, obturation.
| null |
Do not bill along with 97415-00-10, 97417-00-10, 97419-00-10
|
974210000
|
97421-00-00
|
Resorbable root canal filling prim tooth
|
Resorbable root canal filling, primary tooth
| 6
|
Dental services
| 462
|
Pulp treatment
|
the placement of resorbable root canal filling material in a primary tooth.
|
Pulpectomy
| null | null |
974330000
|
97433-00-00
|
Exploratory periradicular surgery
|
Exploratory periradicular surgery
| 6
|
Dental services
| 463
|
Periradicular surgery
|
Surgery to investigate the integrity of the root and surrounding structures
| null | null | null |
974330010
|
97433-00-10
|
Bone graft w periradicular surgery
|
Bone graft with periradicular surgery; per site
| 6
|
Dental services
| 463
|
Periradicular surgery
|
Bone graft in conjunction with periradicular surgery – per tooth
|
Bone graft, non-autogenous graft material
| null | null |
974310000
|
97431-00-00
|
Periapical curettage per root
|
Periapical curettage; per root
| 6
|
Dental services
| 463
|
Periradicular surgery
|
Surgical exposure of the apical section of the root of a pulpless or endodontically treated tooth to remove associated pathological tissue.
| null |
That With: apical seal (filling) of root canal (97434-00-10 [463]), apicectomy (97432-00-00 [463])
| null |
974311000
|
97431-10-00
|
Periodontal curettage & debridement
|
Periodontal curettage and debridement
| 6
|
Dental services
| 463
|
Periradicular surgery
| null | null | null | null |
974320000
|
97432-00-00
|
Apicectomy per root
|
Apicectomy, per root
| 6
|
Dental services
| 463
|
Periradicular surgery
|
Surgical exposure of the apical section of the root of a pulpless or endodontically treated tooth to remove the apical portion of the root, including curettage of the region
|
Periapical curettage, retrograde root filling
|
That with apical seal (filling) of root canal (97434-00-10 [463])
| null |
974340000
|
97434-00-00
|
Apical seal of root canal per canal
|
Apical seal of root canal; per canal
| 6
|
Dental services
| 463
|
Periradicular surgery
|
Debridement and filling of the apical end of a root canal.
|
Apicectomy, periapical curettage
| null | null |
974360000
|
97436-00-00
|
Surgical sealing tooth root perforation
|
Surgical sealing of root perforation; per area perforated
| 6
|
Dental services
| 463
|
Periradicular surgery
|
A surgical procedure of sealing a communication between the pulp canal/chamber and the periradicular tissues due to root perforation.
| null | null | null |
974370000
|
97437-00-00
|
Surg Rx & rep ext root resorp per tooth
|
Surgical treatment and repair of external root resorption; per tooth
| 6
|
Dental services
| 463
|
Periradicular surgery
|
A surgical procedure of sealing a communication between the pulp canal/chamber and the periradicular tissues due to external root resorption.
| null | null |
Requires accompanying description of the procedure or report
|
974380000
|
97438-00-00
|
Hemisection of multi rooted tooth
|
Hemisection of multi rooted tooth
| 6
|
Dental services
| 463
|
Periradicular surgery
|
Separation of a multi-rooted tooth into two parts.
| null | null | null |
974200400
|
97420-04-00
|
Retreatment of previously treated root canal
|
Retreatment of a previously treated root canal
| 6
|
Dental services
| 464
|
Other endodontic service
|
A non‐surgical procedure that involves the removal of root canal filling materials from the tooth, followed by cleaning, shaping and obturating of the canals.
|
Anterior, posterior (Premolar, molar) teeth
| null |
to be coded with any primary root canal procedure repeated within 30 days
|
974450000
|
97445-00-00
|
Expl / negotiation calcified root canal
|
Exploration or negotiation of calcified root canal
| 6
|
Dental services
| 464
|
Other endodontic service
|
Chemical and physical procedure to locate or negotiate abnormally calcified root canal
| null | null | null |
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