Most common D5509 code reviews : Implant/abutment supported interim fixed denture for edentulous arch - maxillary - not covered, Posterior-anterior or lateral skull and facial bone survey radiographic image or Resin-based composite - four or more surfaces or involving the incisal angle (anterior).
Intraoral-complete series (including bitewings). Individually listed intraoral radiographs by the same dentist/dental office are considered a complete series, usually 14-22 images, intended to display the crowns and roots of all teeth, periapical areas and alveolar bone, if the fee for individual radiographs equals or exceeds the fee for a complete series on the same date of service, any fee in excess for the fee for a full mouth series of radiographs is Disallowed.
Procedure in D5509 which the nearly exposed pulp is covered with a protective dressing to protect the pulp from dditional injury and to promote healing and repair via formation of secondary dentin This code is not to be used for bases and iners when all caries has been removed.
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.)
Prefabricated post and core in addition to crown is payable only on a completed endodontically treated tooth. If sufficient tooth structure remains, the fee for the post and core is Disallowed. **A prefabricated post and core for an anterior tooth is Benefited only when there is insufficient tooth structure to support an indirectly fabricated restoration. If sufficient tooth structure remains, the fee for the post and core is Disallowed.