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Insurance
Codes
Since current
dental terminology codes are updated only once every
five years, it is impossible for all new products to
be included. In cases where the procedure is not
adequately described by existing codes, the ADA
recommends that the miscellaneous code (999) be used
with an accompanying descriptive narrative. The
following is a suggested narrative for Sculpture
FibreKor restorations:
"A ceramic based restoration with a
fiber-reinforced framework has been used for this
(these) restorations. This procedure provides
strength similar to metal-reinforced restorations
but also offers the benefit of being able to be
bonded adhesively to the tooth structure, thus
providing additional support. If your policy does
not include the restorative procedure used, please
pay the cast metal or crown equivalent."
Crowns
02740 Crown - porcelain/ceramic substrate
02750 Crown - porcelain fused to high noble
metal
02751 Crown - porcelain fused to predominantly
base metal
02752 Crown - porcelain fused to noble metal
Inlays
02610 Inlay - porcelain/ceramic - one
surface
02620 Inlay - porcelain/ceramic - two
surfaces
02630 Inlay - porcelain/ceramic - three or more
surfaces
Onlays
02642 Onlay - porcelain/ceramic- one surface
02643 Onlay - porcelain/ceramic - two
surfaces
02644 Onlay - porcelain/ceramic - three or more
surfaces
Veneers
02962 Labial veneer (porcelain laminate) -
laboratory
02999 Unspecified restorative procedure by
report
Bridge Abutments
06750 Crown - porcelain fused to high noble
metal
06751 Crown - porcelain fused to predominantly
base metal
06752 Crown - porcelain to noble metal
06240 Pontic - porcelain fused to noble
metal
06241 Pontic - porcelain fused to predominantly
base metal
06242 Pontic - porcelain fused to noble
metal
06999 Unspecified fixed prosthodontic procedure
by report
Resin Restorations
02330 Resin - one surface (anterior)
02331 Resin - two surfaces (anterior)
02332 Resin - three surfaces (anterior)
02335 Resin - four or more surfaces or involving
incisal angle (anterior)
02336 Composite resin crown (anterior
primary)
02380 Resin - one surface (posterior
primary)
02381 Resin - two surfaces (posterior
primary)
02382 Resin - three or more surfaces (posterior
primary)
02385 Resin - one surface (posterior
permanent)
02386 Resin - two surfaces (posterior
permanent)
02387 Resin - three or more surfaces (posterior
permanent)
Inlay Restorations
02610 Inlay - porcelain/ceramic - one
surface
02620 Inlay - porcelain/ceramic - two
surfaces
02630 Inlay - porcelain/ceramic - three
surfaces
02640 Onlay - porcelain/ceramic per tooth (in
addition to inlay)
Crowns - Single Restoration
Only
02710 Crown - resin (laboratory)
02720 Crown - resin with high noble metal
02721 Crown - resin with predominantly base
metal
02722 Crown - resin with noble metal
02740 Crown - porcelain/ceramic substrate
02750 Crown - porcelain fused to high noble
metal
02751 Crown - porcelain fused to predominantly
base metal
02752 Crown - porcelain fused to noble metal
02790 Crown - full cast high noble metal
02791 Crown - full cast high noble predominantly
base metal
02792 Crown - full cast noble metal
02810 Crown - 3/4 cast metallic
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