SBS Code
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11
| SBS Code (Hyphenated)
stringlengths 11
12
| Short Description
stringlengths 3
74
| Long Description
stringlengths 7
544
| Chapter
float64 1
25
⌀ | Chapter Name
stringclasses 25
values | Block
int64 1
4.02k
| Block Name
stringlengths 3
99
⌀ | Definition
stringlengths 11
1.18k
⌀ | Includes
stringlengths 4
1.31k
⌀ | Excludes
stringlengths 1
1.23k
⌀ | Guidelines
stringlengths 1
1.54k
⌀ |
|---|---|---|---|---|---|---|---|---|---|---|---|
974510000
|
97451-00-00
|
R/O root filling per canal
|
Removal of root filling, per canal
| 6
|
Dental services
| 464
|
Other endodontic service
|
Removal of the root filling from a previously obturated canal to enable endodontic retreatment.
| null | null | null |
974520000
|
97452-00-00
|
R/O cemented root cnl post or post crown
|
Removal of cemented root canal post or post crown; per tooth
| 6
|
Dental services
| 464
|
Other endodontic service
| null | null | null | null |
974530000
|
97453-00-00
|
R/O or byps fractured endodontic instrmt
|
Removal or bypass of fractured endodontic instrument
| 6
|
Dental services
| 464
|
Other endodontic service
|
the removal or bypassing of an instrument lodged in the root canal.
| null | null | null |
974550000
|
97455-00-00
|
Irrigtn / dress root cnl system per tth
|
Irrigation and dressing (intracanal medication/medicament) of root canal system
| 6
|
Dental services
| 464
|
Other endodontic service
|
Debridement irrigation and dressing of root canal for infection or inflammation following prior opening and removal of root canal contents
| null | null | null |
974570000
|
97457-00-00
|
Obturation resorption defect/perforation
|
Obturation of resorption defect or perforation
| 6
|
Dental services
| 464
|
Other endodontic service
|
Nonsurgical repair of tooth root perforation
| null | null | null |
974580000
|
97458-00-00
|
Interim therapeutic root filling
|
Interim therapeutic root filling
| 6
|
Dental services
| 464
|
Other endodontic service
|
the insertion of a long-term provisional (temporary) root canal filling with therapeutic properties to facilitates healing/development of the root and periradicular tissues over an extended period of time.
| null | null | null |
976290100
|
97629-01-00
|
Rep or recementation of fabricated/ prefabricated post & core
|
Repair or recementation of fabricated/ prefabricated post and core; per post and core
| 6
|
Dental services
| 464
|
Other endodontic service
| null | null | null | null |
974590010
|
97459-00-10
|
Unlist restorative/endodontic proc
|
Unlisted restorative or endodontic procedure
| 6
|
Dental services
| 464
|
Other endodontic service
| null | null | null |
Used to identify dental procedures which are not described by any other codes. Adequate written description of the service is required.
|
975110100
|
97511-01-00
|
Metallic restoration tooth 1 surf direct
|
Metallic restoration of tooth, one surface, direct
| 6
|
Dental services
| 465
|
Metallic restoration
| null |
Caries excavation
| null | null |
975110200
|
97511-02-00
|
Metallic restoration additional surface direct
|
Metallic restoration of tooth, each additional surface, direct
| 6
|
Dental services
| 465
|
Metallic restoration
| null |
Caries excavation
| null |
to be billed only with 97511-01-10
|
975410100
|
97541-01-00
|
Metallic restor tooth 1 surface indirect
|
Metallic restoration of tooth, one surface, indirect
| 6
|
Dental services
| 465
|
Metallic restoration
| null |
Caries excavation
| null | null |
975410200
|
97541-02-00
|
Metallic restoration additional surf indirect
|
Metallic restoration of tooth, each additional surface, indirect
| 6
|
Dental services
| 465
|
Metallic restoration
| null |
Caries excavation
| null |
to be billed only with 97541-01-10
|
975410300
|
97541-03-00
|
Inlay metallic 1 surf
|
Inlay metallic restoration, one surface, indirect
| 6
|
Dental services
| 465
|
Metallic restoration
|
An inlay is an indirect restoration that fits into the grooves of a tooth, and does not extend over the cusps of the tooth.
|
Tooth preparation, impression & cementation
| null | null |
975410400
|
97541-04-00
|
Inlay metallic additional surf
|
Inlay metallic restoration, each additional surface, indirect
| 6
|
Dental services
| 465
|
Metallic restoration
|
An inlay is an indirect restoration that fits into the grooves of a tooth, and does not extend over the cusps of the tooth.
|
Tooth preparation, impression & cementation
| null |
to be billed only with 97541-03-00 as add on code
|
975410500
|
97541-05-00
|
Onlay metallic 1 surface
|
Onlay metallic restoration, one surface, indirect
| 6
|
Dental services
| 465
|
Metallic restoration
|
An only is an indirect restoration that It is used to fill a larger cavity that extend over the cusps of a tooth. An onlay is larger than an inlay but smaller than a dental crown.
|
Tooth preparation, impression & cementation
| null | null |
975410600
|
97541-06-00
|
Onlay metallic additional surface
|
Onlay metallic restoration, each additional surface, indirect
| 6
|
Dental services
| 465
|
Metallic restoration
|
An only is an indirect restoration that It is used to fill a larger cavity that extend over the cusps of a tooth. An onlay is larger than an inlay but smaller than a dental crown.
|
Tooth preparation, impression & cementation
| null |
to be billed only with 97551-05-00 as add on code
|
975210100
|
97521-01-00
|
Adhesive restor tooth 1 surf direct
|
Adhesive restoration (e.g. compomer, composite, glass ionomer, polymer glass, resin composite), one surface, direct
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
Direct restoration, using an adhesive technique and a tooth-coloured material, involving 1 surface of a tooth.
|
Caries excavation, etching and bonding
| null | null |
975210200
|
97521-02-00
|
Adhesive restoration additional surface direct
|
Adhesive restoration (e.g. compomer, composite, glass ionomer, polymer glass, resin composite), each additional surface, direct
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
Direct restoration, using an adhesive technique and a tooth-coloured material, involving each additional surface.
|
Caries excavation, etching and bonding
| null |
to be billed only with 97521-01-10
|
975510200
|
97551-02-00
|
Inlay porcelain/ ceramic 1 surf indirect
|
Inlay porcelain/ ceramic, one surface, indirect
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
An inlay is an indirect restoration that fits into the grooves of a tooth, and does not extend over the cusps of the tooth.
|
Tooth preparation, impression & cementation
| null | null |
975510300
|
97551-03-00
|
Inlay porcelain/ ceramic indirect additional surf
|
Inlay porcelain/ ceramic, each additional surface, indirect
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
An inlay is an indirect restoration that fits into the grooves of a tooth, and does not extend over the cusps of the tooth.
|
Tooth preparation, impression & cementation
| null |
to be billed only with 97551-02-00 as add on code
|
975510400
|
97551-04-00
|
Onlay porcelain/ ceramic 1 surf
|
Onlay porcelain/ ceramic restoration, one surface, indirect
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
An only is an indirect restoration that It is used to fill a larger cavity that extend over the cusps of a tooth. An onlay is larger than an inlay but smaller than a dental crown.
|
Tooth preparation, impression & cementation
| null | null |
975510500
|
97551-05-00
|
Onlay porcelain/ ceramic additional surf
|
Onlay porcelain/ ceramic restoration, each additional surface, indirect
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
An only is an indirect restoration that It is used to fill a larger cavity that extend over the cusps of a tooth. An onlay is larger than an inlay but smaller than a dental crown.
|
Tooth preparation, impression & cementation
| null |
to be billed only with 97551-04-00 as add on code
|
975510600
|
97551-06-00
|
Inlay resin based composite 1 surf indirect
|
Inlay resin based composite, one surface, indirect
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
An inlay is an indirect restoration that fits into the grooves of a tooth, and does not extend over the cusps of the tooth.
|
Tooth preparation, impression & cementation
| null | null |
975510700
|
97551-07-00
|
Inlay resin based composite indirect additional surf
|
Inlay resin based composite, each additional surface, indirect
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
An inlay is an indirect restoration that fits into the grooves of a tooth, and does not extend over the cusps of the tooth.
|
Tooth preparation, impression & cementation
| null |
to be billed only with 97551-06-00 as add on code
|
975510800
|
97551-08-00
|
Onlay resin based composite 1 surf
|
Onlay resin based composite restoration; one surface, indirect
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
An only is an indirect restoration that It is used to fill a larger cavity that extend over the cusps of a tooth. An onlay is larger than an inlay but smaller than a dental crown.
|
Tooth preparation, impression & cementation
| null | null |
975510900
|
97551-09-00
|
Onlay resin based composite restoration indirect additional surf
|
Onlay resin based composite restoration, each additional surface, indirect
| 6
|
Dental services
| 466
|
Tooth-coloured restoration
|
An only is an indirect restoration that It is used to fill a larger cavity that extend over the cusps of a tooth. An onlay is larger than an inlay but smaller than a dental crown.
|
Tooth preparation, impression & cementation
| null |
to be billed only with 97551-08-00 as add on code
|
975750000
|
97575-00-00
|
Insert dental pin; per pin
|
Insertion of dental pin; per pin
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Insertion of dental pin to aid retention and support of direct or indirect restorations of tooth
| null | null | null |
975750010
|
97575-00-10
|
Core buildup including any pins when required
|
Core buildup including any pins when required
| 6
|
Dental services
| 469
|
Other restorative dental service
|
A procedure where a missing portion of the tooth is restored with a dental filling material in order to support a crown restoration.
|
Pins
| null | null |
975960010
|
97596-00-10
|
Repair of indirect restoration (veneer inlay onlay)
|
Repair of indirect restoration (veneer, inlay, onlay)
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Recementing of previously cemented inlay/onlay or metallic/tooth-coloured restoration
| null | null | null |
975190010
|
97519-00-10
|
Restoration preventive resin; mod/ high caries risk; permanent tooth
|
Restoration using preventive resin; moderate/high caries risk; permanent tooth
| 6
|
Dental services
| 469
|
Other restorative dental service
| null | null | null | null |
975190020
|
97519-00-20
|
Resin infiltration restoration incipient smooth surf lesn
|
Resin infiltration restoration of incipient smooth surface lesions; per surface
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Restoration of an incipient lesion that does not extend into the dentin.
| null | null | null |
975260010
|
97526-00-10
|
Smile analysis
|
Smile analysis
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Consists of examining the patient's face, evaluation of the individual teeth, and material selection considerations.
| null | null | null |
975720100
|
97572-01-00
|
Prov restoration of tooth per tooth
|
Provisional (temporary) restoration, per tooth
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Temporary (intermediate) restoration of a tooth
|
That with any other dental procedure – omit code
| null | null |
975740100
|
97574-01-00
|
Cementation of metal band to tooth
|
Cementation of metal band to tooth; per tooth
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Cementation of metal band for diagnostic, protective purposes or placement of provisional restoration
| null | null |
to be billed by an orthodontist other than the treating physician of the initial procedure.
|
975770000
|
97577-00-00
|
Cusp capping per cusp
|
Cusp capping restoration; per cusp
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Restoration of anatomical or functional height of cusp
|
Caries excavation, etching and bonding
| null | null |
975780000
|
97578-00-00
|
Restor incisal corner ant tth per corner
|
Restoration of incisal corner of anterior tooth; per corner
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Restoration of anatomical and functional shape of incisal corner
|
Caries excavation, etching and bonding
| null | null |
975790100
|
97579-01-00
|
Bonding of tooth fragment
|
Bonding of tooth fragment; per tooth
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Restoration by direct bonding of a tooth fragment
| null | null | null |
975820100
|
97582-01-00
|
Bonding veneer to surface tooth direct
|
Bonding of veneer to tooth surface , direct
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Veneers made of a composite resin material applied directly to the tooth.
| null | null | null |
975830110
|
97583-01-10
|
Attachment veneer to tooth resin laminate indirect
|
Attachment of veneer to tooth surface , resin laminate, indirect
| 6
|
Dental services
| 469
|
Other restorative dental service
|
attachment of tooth-coloured veneer to surface of tooth where veneer is constructed indirectly
|
Tooth preparation, impression & cementation
|
Bonding of veneer to surface of tooth, direct (97582-01-00 [469])
| null |
975830210
|
97583-02-10
|
Attachment veneer to tooth porcelain laminate indirect
|
Attachment of veneer to tooth surface, porcelain laminate, indirect
| 6
|
Dental services
| 469
|
Other restorative dental service
|
attachment of tooth-coloured veneer to surface of tooth where veneer is constructed indirectly
|
Tooth preparation, impression & cementation
|
Bonding of veneer to surface of tooth, direct (97582-01-00 [469])
| null |
975950000
|
97595-00-00
|
R/O indirect restoration
|
Removal of indirect restoration (veneer, inlay, onlay)
| 6
|
Dental services
| 469
|
Other restorative dental service
| null | null | null | null |
975970000
|
97597-00-00
|
Post cast preformed or wrought
|
Post cast, preformed/ wrought; per tooth
| 6
|
Dental services
| 469
|
Other restorative dental service
|
Fabrication and cementation of cast, preformed or wrought post
|
Cementation
| null | null |
976110100
|
97611-01-00
|
All resin (composite acrylic) crown indirect; per crown
|
All resin (composite, acrylic) crown, indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with resin, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976130100
|
97613-01-00
|
Porcelain/ ceramic crown
|
Porcelain/ceramic crown, indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with porcelain/ceramic, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976130200
|
97613-02-00
|
Zirconium crown
|
Zirconium crown, indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with zirconia, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976130300
|
97613-03-00
|
Zirconium fused to ceramic crown
|
Zirconium fused to ceramic crown, indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with zirconium fused to ceramic, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976130400
|
97613-04-00
|
Titanium crown
|
Titanium crown, indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with titanium, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976130500
|
97613-05-00
|
Surveyed crown
|
Surveyed crown; per crown
| 6
|
Dental services
| 470
|
Crown
|
A full coverage restoration or cap that completely covers the tooth and, at the same time, functions under a partial denture.
|
Tooth preparation, impression & cementation
| null | null |
976130600
|
97613-06-00
|
Telescopic crown
|
Telescopic crown; per crown
| 6
|
Dental services
| 470
|
Crown
| null | null | null | null |
976130700
|
97613-07-00
|
Lithium disilicate ceramic crown
|
Lithium disilicate ceramic crown (e max), indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with Lithium disilicate ceramic, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976130800
|
97613-08-00
|
Strip crown
|
Strip crown; per crown
| 6
|
Dental services
| 470
|
Crown
|
A clear plastic-like shell that is filled with tooth-coloured composite material and then fitted over the tooth.
| null | null | null |
976140100
|
97614-01-00
|
Abutment supported crown porcelain/ ceramic
|
Abutment supported crown; porcelain or ceramic
| 6
|
Dental services
| 470
|
Crown
|
An abutment supported crown gains its strength and stability directly from a separate abutment placed on the implant body.
| null | null | null |
976140200
|
97614-02-00
|
Abutment supported crown titanium
|
Abutment supported crown, titanium
| 6
|
Dental services
| 470
|
Crown
|
An abutment supported crown gains its strength and stability directly from a separate abutment placed on the implant body.
| null | null | null |
976140300
|
97614-03-00
|
Abutment supported crown porcelain fused to noble metal
|
Abutment supported crown, porcelain fused to noble metal
| 6
|
Dental services
| 470
|
Crown
|
An abutment supported crown gains its strength and stability directly from a separate abutment placed on the implant body.
| null | null | null |
976140400
|
97614-04-00
|
Abutment supported crown porcelain fused to semiprecious metal
|
Abutment supported crown, porcelain fused to semiprecious metal
| 6
|
Dental services
| 470
|
Crown
|
An abutment supported crown gains its strength and stability directly from a separate abutment placed on the implant body.
| null | null | null |
976151000
|
97615-10-00
|
Porcelain fused to base metal crown
|
Porcelain fused to base metal crown, indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with porcelain fused to base metal, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976180000
|
97618-00-00
|
Full crown metallic indirect
|
All metal crown (steel, palladium, nickel or chromium), indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with cast or milled metal, restoring a natural tooth.
|
Tooth preparation, impression & cementation
|
Gold 97618-03-00
| null |
976180100
|
97618-01-00
|
Prefabricated stainless steel crown permanent tooth
|
Prefabricated stainless steel crown for permanent tooth; per crown
| 6
|
Dental services
| 470
|
Crown
|
Premade full tooth coverage stainless steel crown for permanent teeth.
|
Tooth preparation, impression & cementation
| null | null |
976180200
|
97618-02-00
|
Composite w metal crown
|
Composite with metal crown, indirect; per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with composite and metal, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976180300
|
97618-03-00
|
Crown precious metal (gold)
|
Crown, precious metal (gold), indirect, per crown
| 6
|
Dental services
| 470
|
Crown
|
An artificial crown constructed with gold, restoring a natural tooth.
|
Tooth preparation, impression & cementation
| null | null |
976180400
|
97618-04-00
|
Prefabricated stainless steel crown primary tooth
|
Prefabricated stainless steel crown for primary tooth; per crown
| 6
|
Dental services
| 470
|
Crown
|
Premade full tooth coverage stainless steel crown for primary teeth.
| null | null | null |
976251000
|
97625-10-00
|
Indirectly fabricated post & core
|
Indirectly fabricated post and core; per tooth
| 6
|
Dental services
| 470
|
Crown
| null |
Cementation
| null | null |
976252000
|
97625-20-00
|
Prefabricated post & core
|
Prefabricated post and core, per post and core
| 6
|
Dental services
| 470
|
Crown
| null |
Cementation
| null | null |
976270000
|
97627-00-00
|
Preliminary restor for crown direct
|
Preliminary restoration for crown, direct
| 6
|
Dental services
| 470
|
Crown
|
A direct restoration of the remains of a tooth to provide a base for an intended indirect crown, placed at the same visit as the crown preparation.
|
Tooth preparation, impression & cementation
| null |
Code also when performed: insertion of pin (97575-00-00 [469]), restoration of postcast, preformed or wrought (97597-00-10 [469])
|
976290000
|
97629-00-00
|
Post and root cap indirect
|
Post and root cap, indirect; per tooth
| 6
|
Dental services
| 470
|
Crown
| null |
Cementation
| null | null |
976290200
|
97629-02-00
|
Rmvl post in prosthodontic proc
|
Removal of post in prosthodontic procedures
| 6
|
Dental services
| 470
|
Crown
| null | null | null | null |
976310000
|
97631-00-00
|
Fabrication of temporary crown; per crown
|
Fabrication of temporary crown; per crown
| 6
|
Dental services
| 470
|
Crown
|
Temporary crown, designed to last until a permanent crown is constructed or the tooth is removed
| null | null | null |
976430010
|
97643-00-10
|
Resin bonded FPD
|
Resin bonded fixed partial dentures (rochette, maryland)
| 6
|
Dental services
| 471
|
Bridge
| null |
Tooth preparation, impression & cementation
|
Cantilever fixed partial denture
| null |
976430020
|
97643-00-20
|
Cantilever FPD
|
Cantilever fixed partial denture
| 6
|
Dental services
| 471
|
Bridge
| null |
Tooth preparation, impression & cementation
|
Rochette, Maryland
| null |
976430030
|
97643-00-30
|
High noble metal pontic
|
High noble metal pontic, per pontic
| 6
|
Dental services
| 471
|
Bridge
|
Indirect fabrication of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant.
| null | null | null |
976430040
|
97643-00-40
|
Noble metal pontic
|
Noble metal pontic, per pontic
| 6
|
Dental services
| 471
|
Bridge
|
Indirect fabrication of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant.
| null | null | null |
976430050
|
97643-00-50
|
Resin w metal pontic
|
Resin with metal pontic, per pontic
| 6
|
Dental services
| 471
|
Bridge
|
Indirect fabrication of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant.
| null | null | null |
976430060
|
97643-00-60
|
Porcelain fused metal pontic
|
Porcelain fused metal pontic, per pontic
| 6
|
Dental services
| 471
|
Bridge
|
Indirect fabrication of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant.
| null | null | null |
976430070
|
97643-00-70
|
Porcelain/ ceramic pontic
|
Porcelain/ ceramic pontic, per pontic
| 6
|
Dental services
| 471
|
Bridge
|
Indirect fabrication of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant.
| null | null | null |
976430080
|
97643-00-80
|
Lithium disilicate ceramic pontic
|
Lithium disilicate ceramic pontic (e max), per pontic
| 6
|
Dental services
| 471
|
Bridge
|
Indirect fabrication of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant.
| null | null | null |
976430090
|
97643-00-90
|
Zirconium pontic
|
Zirconium pontic, per pontic
| 6
|
Dental services
| 471
|
Bridge
|
Indirect fabrication of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant.
| null | null | null |
976320000
|
97632-00-00
|
Fabrication of temporary fixed partial denture; per denture
|
Fabrication of temporary fixed partial denture; per denture
| 6
|
Dental services
| 471
|
Bridge
|
Temporary bridge, designed to last until a permanent bridge can be constructed and inserted
|
That with any other dental procedure – omit code
| null | null |
976330000
|
97633-00-00
|
Prov implant abutment per abutment
|
Provisional implant abutment, per abutment
| 6
|
Dental services
| 471
|
Bridge
|
Temporary abutment to an implant, designed to last until permanent abutment(s) can be fitted
| null | null | null |
976340100
|
97634-01-00
|
Prov implant restoration per abutment
|
Provisional implant restoration, per abutment
| 6
|
Dental services
| 471
|
Bridge
|
Temporary restoration of an implant, designed to last until permanent restoration can be placed
| null | null | null |
976420000
|
97642-00-00
|
Bridge pontic direct per pontic
|
Fixed partial denture pontic, direct, per pontic
| 6
|
Dental services
| 471
|
Bridge
| null |
Tooth preparation, impression & cementation
| null | null |
976431010
|
97643-10-10
|
Titanium pontic
|
Titanium pontic, per pontic
| 6
|
Dental services
| 471
|
Bridge
|
Indirect fabrication of an artificial replacement tooth joined to a retainer(s) on an abutment tooth or osseointegrated implant.
| null | null | null |
976440000
|
97644-00-00
|
Semifixed attachment
|
Semifixed attachment
| 6
|
Dental services
| 471
|
Bridge
|
Stress breaker relieves the abutment teeth of all or part of the occlusal forces.
| null | null | null |
976450000
|
97645-00-00
|
Precision or magnetic attachment bridge
|
Precision or magnetic attachment, fixed partial denture
| 6
|
Dental services
| 471
|
Bridge
|
Precision attachment(s) used to lock the denture onto the natural teeth. Precision attachment dentures have two components. the 'male' part is fixed to the natural teeth and the corresponding 'female' part is s incorporated into the denture.
|
Adjustment following insertion of prosthesis
| null | null |
976490000
|
97649-00-00
|
Retainer bonded fixture indir per tooth
|
Retainer for bonded fixture, indirect, per tooth
| 6
|
Dental services
| 471
|
Bridge
|
Retainer and framework bonded to the abutment tooth for support of bridge pontic or precision attachment
|
Adjustment following insertion of prosthesis
| null |
Code also when performed: bridge pontic (97642-00-00, 97643-00-30, 97643-00-40, 97643-00-50, 97643-00-60, 97643-00-70, 97643-00-80, 97643-00-90, 97643-10-10 [471]), splint: metal (97773-00-00 [477]), resin (97772-00-00 [477])
|
976510000
|
97651-00-00
|
Recementing crown or veneer
|
Recementing crown, veneer, onlay, inlay
| 6
|
Dental services
| 472
|
Other dental service on crown and bridge
| null | null | null | null |
976520000
|
97652-00-00
|
Recementing bridge/splint per abutment
|
Recementing/rebonding fixed partial denture or splint
| 6
|
Dental services
| 472
|
Other dental service on crown and bridge
| null | null | null | null |
976550000
|
97655-00-00
|
R/O crown
|
Removal of crown
| 6
|
Dental services
| 472
|
Other dental service on crown and bridge
| null | null | null | null |
976560000
|
97656-00-00
|
R/O bridge or splint
|
Removal of fixed partial denture or splint
| 6
|
Dental services
| 472
|
Other dental service on crown and bridge
| null | null | null | null |
976580000
|
97658-00-00
|
Repair crown bridge or splint indirect
|
Repair of crown, fixed partial denture or splint, indirect
| 6
|
Dental services
| 472
|
Other dental service on crown and bridge
| null | null | null | null |
976590000
|
97659-00-00
|
Repair crown bridge or splint direct
|
Repair of crown, fixed partial denture or splint, direct
| 6
|
Dental services
| 472
|
Other dental service on crown and bridge
| null | null | null | null |
976630000
|
97663-00-00
|
Surg rmvl of dental implant and/or retention device
|
Surgical removal of dental implant and/or retention device; per implant
| 6
|
Dental services
| 473
|
Implant prosthesis
| null | null | null | null |
976630010
|
97663-00-10
|
Implant maintenance
|
Implant maintenance
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Implant maintenance procedures, including removal of prosthesis, cleansing of prosthesis and abutments and reinsertion of prosthesis.
|
Prophylaxis
| null | null |
976680020
|
97668-00-20
|
Rplc semi-precsn attch implt/abtmnt prosth; per attchmnt
|
Replacement of semi-precision attachment (male or female component) of implant/abutment supported prosthesis; per attachment
| 6
|
Dental services
| 473
|
Implant prosthesis
|
A procedure to replace an implant or abutment supported prosthesis.
| null | null | null |
458470100
|
45847-01-00
|
Insert endodontic implant
|
Insertion of endodontic implant; per implant
| 6
|
Dental services
| 473
|
Implant prosthesis
|
An artificial metallic extension, which extends out through the apex of the tooth into bone.
| null | null | null |
458470200
|
45847-02-00
|
Surg placement; mini implant
|
Surgical placement of mini implant; per implant
| 6
|
Dental services
| 473
|
Implant prosthesis
|
A surgically placed dental implant that is fabricated with a reduced diameter (less than 3 mm) and a shorter length but with the same biocompatible material as compared with standard dental implant.
| null | null | null |
458470300
|
45847-03-00
|
Surg placement; eposteal implant
|
Surgical placement of eposteal implant
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Subperiosteal implant that conforms to the superior surface of an edentulous area of alveolar bone.
| null |
Transosteal implant (45847-04-00 [473])
| null |
458470400
|
45847-04-00
|
Surg placement; transosteal implant
|
Surgical placement of transosteal implant
| 6
|
Dental services
| 473
|
Implant prosthesis
|
A Transosteal implant (also referred to as a mandibular staple) is used to support a mandibular denture when the patient has severe resorption with lack of enough bone support for endosseous or Subperiosteal implants.
| null |
Eposteal implant (45847-03-00 [473])
| null |
976610000
|
97661-00-00
|
Fit implant abutment per abtmt
|
Fitting of implant abutment, custom
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Fitting of final implant abutment or replacement .
| null |
Fitting of provisional implant: abutment (97633-00-00 [471]), restoration (97634-01 [471])
| null |
976610100
|
97661-01-00
|
Fitting implant abutment; pre-fabricated
|
Fitting of implant abutment, pre-fabricated
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Fitting of final implant abutment or replacement .
| null | null | null |
976640000
|
97664-00-00
|
Fitting of bar for denture
|
Fitting of bar for denture
| 6
|
Dental services
| 473
|
Implant prosthesis
|
An attachment of a customized bar. This bar provides rigid support through and series of clips to the denture that fits over the top of the bar, which can be used in both the upper and lower jaws.
| null | null | null |
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