SBS Code
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| SBS Code (Hyphenated)
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| Short Description
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| Long Description
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544
| Chapter
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⌀ | Chapter Name
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4.02k
| Block Name
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99
⌀ | Definition
stringlengths 11
1.18k
⌀ | Includes
stringlengths 4
1.31k
⌀ | Excludes
stringlengths 1
1.23k
⌀ | Guidelines
stringlengths 1
1.54k
⌀ |
|---|---|---|---|---|---|---|---|---|---|---|---|
976650000
|
97665-00-00
|
Prosthesis w resin base atchd impl
|
Prosthesis with removable resin base attached to implants, per arch
| 6
|
Dental services
| 473
|
Implant prosthesis
|
A removable prosthesis that is completely or partly supported by an implant or implants, which can be used in both the upper and lower jaws.
| null | null | null |
976660000
|
97666-00-00
|
Prosthesis w metal frame atchd implants
|
Prosthesis with fixed metal frame attached to implants
| 6
|
Dental services
| 473
|
Implant prosthesis
|
A fixed prosthesis that is completely or partly supported by an implant or implants, which can be used in both the upper and lower jaws.
| null | null | null |
976670000
|
97667-00-00
|
Prosth w remv metal frame atchd impl
|
Prosthesis with removable metal frame attached to implants; per arch
| 6
|
Dental services
| 473
|
Implant prosthesis
|
A removable prosthesis that is completely or partly supported by an implant or implants, which can be used in both the upper and lower jaws.
| null | null | null |
976690000
|
97669-00-00
|
R/O and replacement prosthesis fixed to implant; per implant
|
Removal and replacement of prosthesis fixed to implant; per implant
| 6
|
Dental services
| 473
|
Implant prosthesis
|
the removal of a pre-existing prosthesis and replacing it with a new one.
| null | null | null |
976710000
|
97671-00-00
|
Full crwn atchd OI impl nonmet indirect
|
Full crown attached to osseointegrated implant, nonmetallic; indirect
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Artificial crown of tooth-coloured material attached to osseointegrated implant
| null | null | null |
976720000
|
97672-00-00
|
Full crwn atchd OI impl veneered indir
|
Full crown attached to osseointegrated implant, veneered; indirect
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Artificial crown with metallic base veneered with tooth-coloured material attached to osseointegrated implant
| null | null | null |
976730000
|
97673-00-00
|
Full crwn atchd OI impl metallic indir
|
Full crown attached to osseointegrated implant, metallic; indirect
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Artificial crown of cast metal attached to osseointegrated implant
| null | null | null |
976780000
|
97678-00-00
|
Diagnostic template
|
Fabrication of diagnostic template
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Template incorporating radio-opaque markers as reference marks for preferred implant and restoration placement.
| null | null | null |
976790000
|
97679-00-00
|
Surgical implant guide
|
Fabrication of surgical implant guide
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Provision of an appliance which indicates the ideal location and angulation for insertion of implants.
| null | null | null |
976890000
|
97689-00-00
|
Provisional implant
|
Insertion of provisional implant; per implant
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Temporary implant designed with the intention of it being removed at a later stage.
| null | null | null |
976900000
|
97690-00-00
|
Insertion provisional retention dev
|
Insertion of provisional retention device; per unit
| 6
|
Dental services
| 473
|
Implant prosthesis
|
Special purpose provisional retention device intended for later removal attached to the jaws by screws or to implants.
| null | null | null |
977110000
|
97711-00-00
|
Removable complete denture; maxillary
|
Removable complete denture; maxillary
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
|
Removable complete denture; mandibular only (97712-00-00 [474]), maxillary and mandibular (both jaws) (97719-00-00 [474])
|
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977110010
|
97711-00-10
|
Implant supported complete denture; maxillary
|
Implant supported complete denture; maxillary
| 6
|
Dental services
| 474
|
Denture or denture component
|
A complete denture that is completely or partly supported by an implant or implants.
|
Adjustment following insertion of prosthesis
| null |
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977110020
|
97711-00-20
|
Implant supported complete denture; mandibular
|
Implant supported complete denture, mandibular
| 6
|
Dental services
| 474
|
Denture or denture component
|
A complete denture that is completely or partly supported by an implant or implants.
|
Adjustment following insertion of prosthesis
|
that with mandibular denture (97719-00 [474])
|
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977110030
|
97711-00-30
|
Zygomatic implant
|
Zygomatic implant
| 6
|
Dental services
| 474
|
Denture or denture component
|
Zygomatic implants are different from conventional dental implants in that they anchor in to the zygomatic bone (cheek bone) rather than the maxilla (upper jaw).
| null | null | null |
977120000
|
97712-00-00
|
Removable complete denture; mandibular
|
Removable complete denture; mandibular
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
|
Removable complete denture; maxillary only (97711-00-00 [474]), maxillary and mandibular (both jaws) (97719-00-00 [474])
|
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977120010
|
97712-00-10
|
Implant supported complete denture provisional; maxillary
|
Implant supported complete denture, provisional (temporary); maxillary
| 6
|
Dental services
| 474
|
Denture or denture component
|
A temporary complete denture that is completely or partly supported by an implant or implants, designed for use over a limited period of time.
| null | null |
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977190000
|
97719-00-00
|
Removable complete denture; maxillary & mandibular
|
Removable complete denture, maxillary and mandibular
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
|
Removable complete denture; maxillary only (97711-00-00 [474]), mandibular only (97712-00-00 [474])
|
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977190010
|
97719-00-10
|
Removable complete overdenture
|
Removable complete overdenture; per jaw
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null |
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977190020
|
97719-00-20
|
Removable partial overdenture
|
Removable partial overdenture; per jaw
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null |
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977190030
|
97719-00-30
|
Porcelain/ceramic abutment for resin bonded fixed prosthesis
|
Porcelain/ ceramic abutment for resin bonded fixed prosthesis, per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977190040
|
97719-00-40
|
Porcelain fused metal abutment
|
Porcelain fused metal abutment, per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977270000
|
97727-00-00
|
Interim partial maxillary denture metal
|
Interim partial maxillary denture, metal framework with resin
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
| null | null |
977270010
|
97727-00-10
|
One piece cast metal removable partial denture per jaw
|
One piece cast metal removable partial denture, per jaw
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Tooth preparation & impression. Adjustment following insertion of prosthesis
| null |
Code also when performed: attachment of: occlusal rests (97732-00-00 [474]), retainer (97731-00-00 [474]), immediate replacement of tooth (97736-00-10 [474]), overlay (97734-00-10 [474])
|
977130010
|
97713-00-10
|
Implant supported complete denture provisional; mandibular
|
Implant supported complete denture, provisional (temporary);mandibular
| 6
|
Dental services
| 474
|
Denture or denture component
|
A temporary complete denture that is completely or partly supported by an implant or implants, designed for use over a limited period of time.
| null | null |
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977130020
|
97713-00-20
|
Interim complete maxillary denture
|
Interim complete maxillary denture
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
| null | null |
977140010
|
97714-00-10
|
Interim complete mandibular denture
|
Interim complete mandibular denture
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
| null | null |
977150010
|
97715-00-10
|
Interim complete maxillary & mandibular dentures
|
Interim complete maxillary and mandibular dentures
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
| null | null |
977160000
|
97716-00-00
|
Insert metal palate or plate
|
Insertion of metal palate or plate or any other shape with reinforced metal (casted or prefabricated) to base of resin denture
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977190110
|
97719-01-10
|
Primary impression maxilla /mandible for denture processing
|
Primary impression for maxilla /mandible for denture processing
| 6
|
Dental services
| 474
|
Denture or denture component
|
A negative replica of oral tissues and teeth. Includes impressions for Overdentures, immediate, interim, partial, and complete removable dentures.
| null | null |
Non billable, to be claimed with zero value as it is inclusive in the main procedure
|
977190120
|
97719-01-20
|
Border molding
|
Border molding
| 6
|
Dental services
| 474
|
Denture or denture component
|
Shaping of the border areas of an impression tray by functional or manual manipulation of the tissue adjacent to the borders to duplicate the contour and size of the vestibule.
| null | null |
Non billable, to be claimed with zero value as it is inclusive in the main procedure
|
977190130
|
97719-01-30
|
Final impression maxilla/mandible
|
Final impression for maxilla / mandible
| 6
|
Dental services
| 474
|
Denture or denture component
|
A negative replica of oral tissues and teeth. Includes impressions for Overdentures, immediate, interim, partial, and complete removable dentures.
| null | null |
Non billable, to be claimed with zero value as it is inclusive in the main procedure
|
977190140
|
97719-01-40
|
Face bow transfer
|
Face bow transfer
| 6
|
Dental services
| 474
|
Denture or denture component
|
A facebow is an instrument that records the relationship of the maxilla to the hinge axis of rotation of the mandible. It allows a maxillary cast to be placed in an equivalent relationship on the articulator.
| null | null |
Non billable, to be claimed with zero value as it is inclusive in the main procedure
|
977190150
|
97719-01-50
|
Bite registration
|
Bite registration
| 6
|
Dental services
| 474
|
Denture or denture component
|
An impression of the occlusal relationship of the maxilla and mandible.
| null | null |
Non billable, to be claimed with zero value as it is inclusive in the main procedure
|
977190160
|
97719-01-60
|
Try in upper/lower denture
|
Try in of the upper / lower denture
| 6
|
Dental services
| 474
|
Denture or denture component
|
A wax try-in of the denture teeth is an important step in the fabricating process. This allows the dentist to confirm fit and function and allows the patient to preview their new smile before it is finished.
| null | null |
Non billable, to be claimed with zero value as it is inclusive in the main procedure
|
977190170
|
97719-01-70
|
Denture insert
|
Denture insertion
| 6
|
Dental services
| 474
|
Denture or denture component
|
Delivery of denture.
| null | null |
Non billable, to be claimed with zero value as it is inclusive in the main procedure
|
977190180
|
97719-01-80
|
Tooth preparation for crown/ FPD
|
Tooth preparation for crown or fixed partial denture
| 6
|
Dental services
| 474
|
Denture or denture component
|
Removal of all defects, and provide necessary protection to the pulp along with necessary tooth preparation to fit the crown/FPD.
| null | null |
Non billable, to be claimed with zero value as it is inclusive in the main procedure
|
977210000
|
97721-00-00
|
Prov prt maxillary denture resin base
|
Interim partial maxillary denture resin base
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
| null | null |
977210010
|
97721-00-10
|
Resin base per abutment
|
Resin base, per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977210020
|
97721-00-20
|
Titanium abutment
|
Titanium abutment, per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977210030
|
97721-00-30
|
Lithium disilicate ceramic abutment
|
Lithium disilicate ceramic abutment (e max), per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977210040
|
97721-00-40
|
Zirconium abutment
|
Zirconium abutment, per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977210050
|
97721-00-50
|
High noble metal abutment
|
High noble metal abutment, per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977210060
|
97721-00-60
|
Noble metal abutment
|
Noble metal abutment, per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977210070
|
97721-00-70
|
Resin w metal abutment
|
Resin with metal abutment, per abutment
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977210080
|
97721-00-80
|
Flexible base removable partial denture per jaw
|
Flexible base removable partial denture, per jaw
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Tooth preparation & impression. Adjustment following insertion of prosthesis
| null |
Code also when performed: attachment of: occlusal rests (97732-00-00 [474]), retainer (97731-00-00 [474]), immediate replacement of tooth (97736-00-10 [474]), overlay (97734-00-10 [474])
|
977220000
|
97722-00-00
|
Prov prt mandibular denture resin base
|
Interim partial mandibular denture resin base
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
| null | null |
977280000
|
97728-00-00
|
Prov prt mandibular denture cast metal
|
Interim partial mandibular denture, metal framework with resin
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Impression.Adjustment following insertion of prosthesis
| null | null |
977310000
|
97731-00-00
|
Insert retainer to partial denture
|
Insertion of retainer to partial denture
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977320000
|
97732-00-00
|
Prov occlusal rest part denture per rest
|
Occlusal rest to removable partial denture in the framework, per rest
| 6
|
Dental services
| 474
|
Denture or denture component
|
Unit of a partial denture that rests upon tooth surface to support denture
|
Adjustment following insertion of prosthesis
|
That where used as part of retainer (97731-00-00 [474])
| null |
977340000
|
97734-00-00
|
Overlay per tooth
|
Overlay, per tooth
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Tooth preparation & impression. Adjustment following insertion of prosthesis
| null |
Code also when performed: provision of complete denture: mandibular (97712-00-00 [474]), maxillary (97711-00-00 [474]), provision of partial cast metal denture (97727-00-10 [474]), provision of partial resin base denture (97721-00-10 [474])
|
977350000
|
97735-00-00
|
Precision or magnetic attachment denture
|
Precision or magnetic attachment, denture
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977360000
|
97736-00-00
|
Immediate replacement tooth per tooth
|
Immediate replacement of tooth, per tooth
| 6
|
Dental services
| 474
|
Denture or denture component
|
Provision within a denture to allow immediate replacement of an extracted tooth.
|
Tooth preparation & impression. Adjustment following insertion of prosthesis
| null |
Code also when performed: provision of complete denture: mandibular (97712-00-00 [474]), maxillary (97711-00-00 [474]), provision of partial cast metal denture (97727-00-10 [474]), provision of partial resin base denture (97721-00-10 [474])
|
977370000
|
97737-00-00
|
Resilient lining
|
Resilient lining
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null |
May be used with the provision of a new, or the maintenance of a pre-existing prosthesis.
|
977380000
|
97738-00-00
|
Prov connecting bar of wrought metal
|
Fabrication of connecting bar of wrought metal
| 6
|
Dental services
| 474
|
Denture or denture component
| null |
Adjustment following insertion of prosthesis
| null | null |
977390000
|
97739-00-00
|
Prov metal bck denture tooth per bck
|
Fabrication of metal backing for denture tooth, per backing
| 6
|
Dental services
| 474
|
Denture or denture component
|
Extension of casting of cast metal partial denture to provide backing for denture tooth
| null | null | null |
977410000
|
97741-00-00
|
Adjustment of denture
|
Adjustment of denture
| 6
|
Dental services
| 475
|
Denture maintenance
|
Adjust of pre-existing denture
| null |
Routine Adjust of new dentures – omit code
|
Does not apply to routine modification following the insertion of a new denture.
|
977430010
|
97743-00-10
|
Direct relining removable complete denture
|
Direct relining of removable complete denture, per jaw (in clinic)
| 6
|
Dental services
| 475
|
Denture maintenance
| null | null | null | null |
977430015
|
97743-00-15
|
Direct relining removable partial denture
|
Direct relining of removable partial denture, per jaw (in clinic)
| 6
|
Dental services
| 475
|
Denture maintenance
| null | null | null | null |
977430020
|
97743-00-20
|
Indirect relining removable complete denture
|
Indirect relining of removable complete denture, per jaw (in laboratory)
| 6
|
Dental services
| 475
|
Denture maintenance
| null | null | null | null |
977430025
|
97743-00-25
|
Indirect relining removable partial denture
|
Indirect relining of removable partial denture, per jaw (in laboratory)
| 6
|
Dental services
| 475
|
Denture maintenance
| null | null | null | null |
977450000
|
97745-00-00
|
Remodelling of complete denture
|
Remodelling of complete denture
| 6
|
Dental services
| 475
|
Denture maintenance
| null | null | null | null |
977460000
|
97746-00-00
|
Rebase of removable partial denture
|
Rebase of removable partial denture; per jaw
| 6
|
Dental services
| 475
|
Denture maintenance
| null | null | null | null |
977530000
|
97753-00-00
|
Clean & polish pre-existing denture
|
Cleaning and polishing of pre-existing denture
| 6
|
Dental services
| 475
|
Denture maintenance
| null | null |
Cleaning and polishing of new denture – omit code
| null |
977540000
|
97754-00-00
|
Modification of denture base
|
Modification of denture base
| 6
|
Dental services
| 475
|
Denture maintenance
| null | null | null |
Does not apply to routine modification following the insertion of a new denture.
|
977640000
|
97764-00-00
|
Repair broken base of complete denture
|
Repair of broken base of partial or complete denture
| 6
|
Dental services
| 476
|
Denture repair
| null | null | null | null |
977610000
|
97761-00-00
|
Reattachment pre-exst clasp to denture
|
Reattachment of pre-existing clasp to denture
| 6
|
Dental services
| 476
|
Denture repair
|
Repair, insertion and adjustment of denture involving reattachment of pre-existing clasp
| null | null | null |
977620000
|
97762-00-00
|
Replacement / add new clasp to denture
|
Replacement or addition of a new clasp to denture
| 6
|
Dental services
| 476
|
Denture repair
|
Repair, insertion and adjustment of denture involving replacement of a new clasp(s)
| null | null | null |
977650000
|
97765-00-00
|
Repair of broken base of partial denture
|
Replacement of a new tooth on denture, per tooth
| 6
|
Dental services
| 476
|
Denture repair
|
Repair, insertion and adjustment of denture involving replacement with a new tooth to a pre-existing denture
| null | null | null |
977660100
|
97766-01-00
|
Replacement / add new tooth on denture
|
Reattaching existing tooth on denture, per tooth
| 6
|
Dental services
| 476
|
Denture repair
|
Repair, insertion and adjustment of a denture involving reattachment of a pre-existing denture tooth
| null | null | null |
977680000
|
97768-00-00
|
Reattaching existing tooth on denture
|
Addition of tooth to partial denture to replace extracted or decoronated tooth, per tooth
| 6
|
Dental services
| 476
|
Denture repair
|
Modification, insertion and adjustment of partial denture involving addition to accommodate loss of natural tooth or its coronal section
|
Abutment Tooth clasp
| null |
Code also when performed: immediate tooth replacement (97736-00-10 [474]).
|
977690000
|
97769-00-00
|
Add tth prt dent replace extr / deco tth
|
Repair or addition to metal casting
| 6
|
Dental services
| 476
|
Denture repair
|
Repair or addition to metal cast frame of partial denture
| null | null | null |
976140500
|
97614-05-00
|
Re-cement/ re-bond implant/abutment supported crown
|
Re-cementing or re-bonding implant/abutment supported crown
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null |
That for implant/abutment supported fixed partial denture
|
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977110040
|
97711-00-40
|
Re-cement/re-bond implnt/abutment spptd fxd part denture
|
Re-cementing or re-bonding implant/abutment supported fixed partial denture
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null |
Adjustment following insertion of prosthesis
Removal and replacement of fixture or abutment screw
|
That for implant/abutment supported crown
|
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977110080
|
97711-00-80
|
Rep implant supported prosthesis other
|
Repair implant supported prosthesis, other
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null |
Adjustment following insertion of prosthesis
| null |
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977110090
|
97711-00-90
|
Rep implant abutment other
|
Repair implant abutment, other
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null |
Adjustment following insertion of prosthesis
| null |
Code also when performed: immediate tooth replacement (97736-00-10 [474]), overlay (97734-00-10 [474]), provision of metal palate or plate (97716-00-00 [474]), resilient lining in addition to new denture (97737-00-00 [474])
|
977710000
|
97771-00-00
|
Tissue conditioning preparatory impressions
|
Tissue conditioning; per jaw
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null | null | null |
977720000
|
97772-00-00
|
Resin splint indirect
|
Provision of resin splint, indirect
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null |
Impression and the subsequent removal of the splint.
| null | null |
977730000
|
97773-00-00
|
Metal splint indirect
|
Provision of metal splint, indirect
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null |
Impression and the subsequent removal of the splint.
| null | null |
977740000
|
97774-00-00
|
Obturator prosthesis
|
Provision of definitive obturator prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null |
Interim obturator prosthesis (97774-00-10 [477]), Surgical obturator prosthesis (97774-00-20 [477])
| null |
977740010
|
97774-00-10
|
Interim obturator prosthesis
|
Interim obturator prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null |
Definitive obturator prosthesis (97774-00-00 [477]), Surgical obturator prosthesis (97774-00-20 [477])
| null |
977740020
|
97774-00-20
|
Surg obturator prosthesis
|
Surgical obturator prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
|
A surgical obturator is fabricated from the impression made before the surgical excision of the lesion and inserted immediately after the surgery.
| null |
Definitive obturator prosthesis (97774-00-00 [477]), Interim obturator prosthesis (97774-00-10 [477])
| null |
977740030
|
97774-00-30
|
Interim palatal lift prosthesis
|
Interim palatal lift prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null |
Definitive palatal lift prosthesis (97774-00-40 [477])
| null |
977740040
|
97774-00-40
|
Definitive palatal lift prosthesis
|
Definitive palatal lift prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null |
Interim palatal lift prosthesis (97774-00-30 [477])
| null |
977740050
|
97774-00-50
|
Palatal augmentation prosthesis
|
Palatal augmentation prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null | null | null |
977740060
|
97774-00-60
|
Mandibular resection prosthesis
|
Mandibular resection prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null | null | null |
977740070
|
97774-00-70
|
Pediatric speech aid prosthesis
|
Pediatric speech aid prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
|
A temporary prosthesis to improve speech for pediatric patients – normal lateral growth requires occasional replacement of the prosthesis.
| null |
Adult speech aid prosthesis (97774-00-70 [477])
| null |
977740080
|
97774-00-80
|
Adult speech aid prosthesis
|
Adult speech aid prosthesis
| 6
|
Dental services
| 477
|
Other prosthodontic service
|
Improves speech for adults. When no further growth is anticipated.
| null |
Pediatric speech aid prosthesis (97774-00-70 [477])
| null |
977741000
|
97774-10-00
|
Nasal prosthesis
|
Nasal prosthesis (maxillofacial prosthesis)
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null | null |
Synonym: Artificial nose.
|
977741010
|
97774-10-10
|
Auricular prosthesis
|
Auricular prosthesis (maxillofacial prosthesis)
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null | null |
Synonym: Artificial ear.
|
977741020
|
97774-10-20
|
Orbital prosthesis
|
Orbital prosthesis (maxillofacial prosthesis)
| 6
|
Dental services
| 477
|
Other prosthodontic service
|
A prosthesis which restores the eye, eyelids, and adjacent soft and hard tissue, lost due to trauma or surgery.
| null | null | null |
977741030
|
97774-10-30
|
Ocular prosthesis
|
Ocular prosthesis (maxillofacial prosthesis)
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null | null |
Synonym: Artificial eye.
|
977741040
|
97774-10-40
|
Facial prosthesis
|
Facial prosthesis (maxillofacial prosthesis)
| 6
|
Dental services
| 477
|
Other prosthodontic service
|
A removable prosthesis which replaces a portion of the face lost due to trauma, surgery or congenital absence.
| null | null |
Synonym: prosthetic face.
|
977741050
|
97774-10-50
|
Cranial prosthesis
|
Cranial prosthesis (maxillofacial prosthesis)
| 6
|
Dental services
| 477
|
Other prosthodontic service
| null | null | null |
Synonym: Cranioplasty prosthesis, cranial implant, scull plate.
|
977780000
|
97778-00-00
|
Metallic inlay for denture tooth
|
Metallic inlay for removable denture tooth; per tooth
| 6
|
Dental services
| 477
|
Other prosthodontic service
|
Provision of metallic restoration for denture tooth
| null | null | null |
977790100
|
97779-01-00
|
Surg guide for immediate denture
|
Fabrication of surgical guide for immediate denture
| 6
|
Dental services
| 477
|
Other prosthodontic service
|
Provision of appliance to indicate final ridge contours following extraction of teeth, prior to immediate denture insertion
| null | null | null |
97789-01-00
|
97789-00-10
|
Unlist prosthodontic proc
|
Unlisted prosthodontic procedure
| 6
|
Dental services
| 477
|
Other prosthodontic 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.
|
978230000
|
97823-00-00
|
Functional ortho appliance; excluding prefabricated
|
Insertion of functional orthopaedic appliance; excluding prefabricated
| 6
|
Dental services
| 479
|
Removable orthodontic appliance
|
A custom made removable appliance that corrects the way the teeth bite together by directing orthopaedic and muscular forces
| null |
Pre-fabricated
| null |
978230010
|
97823-00-10
|
Functional orthopaedic appliance prefabricated
|
Insertion of functional orthopaedic appliance; prefabricated
| 6
|
Dental services
| 479
|
Removable orthodontic appliance
|
A prefabricated removable appliance that corrects the way the teeth bite together by directing orthopaedic and muscular forces
| null |
Custom made
| null |
978110000
|
97811-00-00
|
Passive removable aplnce max arch
|
Insertion of passive removable appliance, maxillary arch
| 6
|
Dental services
| 479
|
Removable orthodontic appliance
|
A removable maxillary arch appliance that has no force to move the teeth
| null |
Passive removable appliance, mandibular arch
| null |
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