Most common D1513 code reviews : Implant/abutment supported interim fixed denture for edentulous arch - maxillary - not covered, Bone replacement graft - retained natural tooth - each additional site in quadrant or Accession of tissue, gross examination, preparation and transmission of written report.
Prophylaxis-adult. For payment purposes, the distinction between the adult and child dentition is determined by contract. Any fee in excess is Disallowed and not chargeable to the Patient. In the absence of group contract language regarding age, a person age fourteen (14) and older is considered an adult for benefit determination purposes of a prophylaxis-adult.
Separation of one or more connections between abutments and/or pontics when some portion of a fixed rosthesis is to remain intact D1513 and serviceable following sectioning and extraction or other treatment Includes all recontouring and olishing of retained portions.
Dental case management - patient education to improve oral health literacy. (Not covered service as opposed to when performed as follows: Disallowed when performed on same date of service as nutrition, tobacco counseling and/or oral hygiene instructions.)
Sealant repair - per tooth - This procedure is disallowed when performed by the same dentist/dental office based on the same time limitation that exists for replacement of a sealant. It is allowed at 50% of D1513 when performed by a different provider or if after the time limitation for the same dentist.