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Dental Customer Service - Appeals. Find a Provider. Is this for me? Or call 1-844-653-4057. The report suggests changing funding and reimbursement for dental care; expanding the oral health work force by training doctors, nurses, and other nondental professionals to recognize risk for oral diseases; and revamping regulatory, ... Register for MyBlue. Dental Claims Administrator PO Box 69406 Harrisburg, PA 17106-9406, Dental Claims Administrator PO Box 69401 Harrisburg, PA 17106-9401. Clinical Tips and Caution boxes interspersed throughout the text highlight key clinical points. Glossary at the end of the book provides definitions of laser terminology. Pursuant to Section 1557 Blue Cross Blue Shield FEP Dental does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, age, disability, or sex . Services and products may be provided through Horizon Blue Cross Blue Shield of New Jersey, Horizon Healthcare of New Jersey, Inc., Horizon Healthcare Dental, Inc., Horizon Casualty Services, Inc., or Horizon NJ Health*, a product of Horizon HMO, each of which is an independent licensee of the Blue Cross Blue Shield Association. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Dental insurance makes it affordable. Found inside – Page 196Dr. Thomas Levickas wrote to the Subcommittee on behalf of his dental practice in Pasadena , Maryland . Dr. Levickas has a provider agreement with the Maryland Dental Plan of Blue Cross and Blue Shield which he feels is " by far the ... ©2021 Blue Cross and Blue Shield of Florida, Inc. Found inside – Page 76Traditional fee - for - service1 Self insured2 Commercial insurance company Blue Cross / Blue Shield Independent organization 3 Combined financed4 Dental society Not determinable Preferred provider organization ? CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. Example: One hour of anesthesia; the first would be D9222 (FIRST 15 MINUTES) then D9223 (EACH SUBSEQUENT 15 MINUTE INCREMENT) with units showing as 3. CDT codes are developed by the ADA and are the only HIPAA-recognized code set for dentistry. CDT 2021 codes go into effect on January 1, 2021. -- American Dental Association We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability, or sex, including sexual orientation, gender identity, or gender expression. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Predeterminations will be valid for 1 year from when the service was approved. Voluntary dental plans. DNoA contracts with go2dental.com, Inc., an independent company that provides dental website information and tools for BCBSOK plans. To find out if your plan includes pediatric dental coverage, please check your Summary of Benefits and Coverage . . For J.D. Policies and procedures to assist providers in filling dental claims, referral requests and other services. Blue Dental. We’re ready to help. Read our Nondiscrimination and Language Assistance notice. REPORT THE SURGICAL EXPOSURE SEPERATELY USING D7280. Patient information such as eligibility, benefits, claim status, maximums/ deductibles, procedure history, procedure code information, orthodontic information and Maximum Allowable Charge schedules can be obtained through My Patients’ Benefits and can be accessed at wy.ourdentalcoverage.com. Found inside – Page 170Frequently , the judgement of the provider is undermined when treatment decisions are made in the best interest of the patient ... of the Blue Cross / Blue Shield indemnity plans were recently converted to Blue Cross / Blue Shield HMO . Providers can insert the date of service in My Patients’ Benefits via the Claim Status feature; or can insert the date of service on the Predetermination Notification form and return it via the USPS. Register for My Patients’ Benefits at: wy.ourdentalcoverage.com and submit your claims electronically through Speed eClaim®. Search our directory of providers or call 1-855-504-BLUE (2583). Find a Provider. Dental services covered under the member's medical benefits. Blue Cross Blue Shield members can search for doctors, hospitals and dentists: Select Blue Cross Blue Shield Global™ or GeoBlue if you have international coverage and need to find care outside the United States. We have numerous dental plans for individual and employer coverage. Dental Provider Manual. If you would like personal information on your family's eligibility, benefits or claim status, please call Customer Service at 888-223-4999. Calendar Year Deductible: $50 per person. BlueDental from Blue Cross ® Blue Shield ® of Arizona (BCBSAZ) offers benefits everyone loves, including $0 cleanings, X-rays, and exams, plus low-cost coverage for dental services like orthodontia, fillings, implants, and more. Dental Blue Book eManual View or download our online guide to policies and procedures for dental providers. . Apply for Enrollment and Credentialing Get guidelines and instructions for applying for credentialing as a dental provider. This is the most we will pay each year. Operating hours are Monday - Friday from 7 a.m. - 5 p.m. CST. Blue Cross Blue Shield FEP Dental SM. Choose a dental network from the list below to search for a dentist. To do this, you may contact the Dental Provider Services at 1-800-882-1178. Compare and Enroll. TRANSSEPTAL FIBEROTOMY/SUPRA CRESTAL FIBEROTOMY, BY REPORT, ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEETH OR TOOTH SPACES, PER QUADRANT, ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE TEETH OR TOOTH SPACES, PER QUANDRANT, ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEETH OR TOOTH SPACES, PER QUADRANT, ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE TEETH OR TOOTH SPACES, PER QUADRANT, VESTIBULOPLASTY - RIDGE EXTENSION (SECONDARY EPITHELIALIZATION), VESTIBULOPLASTY - RIDGE EXTENSION (INCLUDING SOFT TISSUE GRAFTS, MUSCLE REATTACHMENT, REVISION OF SOFT TISSUE ATTACHMENT AND MANAGEMENT OF HYPERTROPHIED AND HYPERPLASTIC TISSUE), INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE, INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE - COMPLICATED (INCLUDES DRAINAGE OF MULTIPLE FASCIAL SPACES), SURGICAL DISCECTOMY, WITH/WITHOUT IMPLANT, ARTHROSCOPY - DIAGNOSTIC, WITH OR WITHOUT BIOPSY, ARTHROSCOPY: LAVAGE AND LYSIS OF ADHESIONS, ARTHROSCOPY: DISC REPOSITIONING AND STABILIZATION, PLACEMENT OF INTRA-SOCKET BIOLOGICAL DRESSING TO AID IN HEMOSTASIS OR CLOT STABILIZATION, PER SITE, LEFORT II OR LEFORT III (OSTEOPLASTY OF FACIAL BONE FOR MIDFACE HYPOPLASIA OR RETRUSION) - WITHOUT BONE GRAFT, OSSEOUS, OSTEOPERIOSTEAL, OR CARTILAGE GRAFT OF THE MANDIBLE OR MAXILLA - AUTOGENOUS OR NONAUTOGENOUS, BY REPORT, FRENULECTOMY - ALSO KNOWN AS FRENECTOMY OR FRENOTOMY - SEPARATE PROCEDURE NOT INCIDENTAL TO ANOTHER PROCEDURE, SYNTHETIC GRAFT - MANDIBLE OR FACIAL BONES, BY REPORT, APPLIANCE REMOVAL (NOT BY DENTIST WHO PLACED APPLIANCE), INCLUDES REMOVAL OF ARCHBAR, INTRAORAL PLACEMENT OF A FIXATION DEVICE NOT IN CONJUNCTION WITH A FRACTURE, UNSPECIFIED ORAL SURGICAL PROCEDURE, BY REPORT, LIMITED ORTHODONTIC TREATMENT OF THE PRIMARY DENTITION, LIMITED ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION, LIMITED ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION, LIMITED ORTHODONTIC TREATMENT OF THE ADULT DENTITION, INTERCEPTIVE ORTHODONTIC TREATMENT OF THE PRIMARY DENTITION, INTERCEPTIVE ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION, COMPREHENSIVE ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION, COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION, COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADULT DENTITION, ORTHODONTIC RETENTION (REMOVAL OF APPLIANCE, CONSTRUCTION AND PLACEMENT OF RETAINER(S)), PRE-ORTHODONTIC TREATMENT EXAMINATION TO MONITOR GROWTH AND DEVELOPMENT, ORTHODONTIC RETENTION (REMOVAL OF APPLIANCES, CONSTRUCTION AND PLACEMENT OF RETAINER(S)), REMOVABLE ORTHODONTIC RETAINER ADJUSTMENT, ORTHODONTIC TREATMENT, (ALTERNATIVE BILLING TO A CONTRACT FEE), REMOVAL OF FIXED ORTHODONTIC APPLIANCES FOR REASONS OTHER THAN COMPLETION OF TREATMENT, REPAIR OF ORTHODONTIC APPLIANCE - MAXILLARY, REPAIR OF ORTHODONTIC APPLIANCE - MANDIBULAR, RE-CEMENT OR RE-BOND FIXED RETAINER - MAXILLARY, RE-CEMENT OR RE-BOND FIXED RETAINER - MANDIBULAR, REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MAXILLARY, REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MANDIBULAR, REPLACEMENT OF LOST OR BROKEN RETAINER - MAXILLARY, REPLACEMENT OF LOST OR BROKEN RETAINER - MANDIBULAR, UNSPECIFIED ORTHODONTIC PROCEDURE, BY REPORT, PALLIATIVE (EMERGENCY) TREATMENT OF DENTAL PAIN - MINOR PROCEDURES, LOCAL ANESTHESIA NOT IN CONJUNCTION WITH OPERATIVE OR SURGICAL PROCEDURES, LOCAL ANESTHESIA IN CONJUNCTION WITH OPERATIVE OR SURGICAL PROCEDURES, EVALUATION FOR MODERATE SEDATION, DEEP SEDATION OR GENERAL ANESTHESIA, DEEP SEDATION/GENERAL ANESTHESIA - FIRST 15 MINUTES, DEEP SEDATION/GENERAL ANESTHESIA - EACH SUBSEQUENT 15 MINUTE INCREMENT, INHALATION OF NITROUS OXIDE/ANXIOLYSIS, ANALGESIA, INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA- FIRST 15 MINUTES, INTRAVENOUS MODERATE (CONSCIOUS) SEDATION/ANALGESIA - EACH SUBSEQUENT 15 MINUTE INCREMENT, CONSULTATION - DIAGNOSTIC SERVICE PROVIDED BY DENTIST OR PHYSICIAN OTHER THAN REQUESTING DENTIST OR PHYSICIAN, CONSULTATION WITH A MEDICAL HEALTH CARE PROFESSIONAL, HOSPITAL OR AMBULATORY SURGICAL CENTER CALL, OFFICE VISIT FOR OBSERVATION (DURING REGULARLY SCHEDULED HOURS) - NO OTHER SERVICES PERFORMED, OFFICE VISIT - AFTER REGULARLY SCHEDULED HOURS, CASE PRESENTATION, DETAILED AND EXTENSIVE TREATMENT PLANNING, THERAPEUTIC PARENTERAL DRUG, SINGLE ADMINISTRATION, THERAPEUTIC PARENTERAL DRUGS, TWO OR MORE ADMINISTRATIONS, DIFFERENT MEDICATIONS, INFILTRATION OF SUSTAINED RELEASE THERAPEUTIC DRUG- SINGLE OR MULTIPLE SITES, DRUGS OR MEDICAMENTS DISPENSED IN THE OFFICE FOR HOME USE, APPLICATION OF DESENSITIZING RESIN FOR CERVICAL AND/OR ROOT SURFACE, PER TOOTH, TREATMENT OF COMPLICATIONS (POST-SURGICAL) - UNUSUAL CIRCUMSTANCES, BY REPORT, CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MAXILLARY, CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MANDIBULAR, CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MAXILLARY, CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MANDIBULAR, OCCLUSAL GUARD - HARD APPLIANCE, FULL ARCH, OCCLUSAL GUARD - SOFT APPLIANCE, FULL ARCH, OCCLUSAL GUARD- HARD APPLIANCE, PARTIAL ARCH, ODONTOPLASTY 1-2 TEETH; INCLUDES REMOVAL OF ENAMEL PROJECTIONS, EXTERNAL BLEACHING - PER ARCH - PERFORMED IN OFFICE, EXTERNAL BLEACHING FOR HOME APPLICATION, PER ARCH; INCLUDES MATERIALS AND FABRICATION OF CUSTOM TRAYS, DENTAL CASE MANAGEMENT ADDRESSING APPOINTMENT COMPLIANCE BARRIERS, DENTAL CASE MANAGEMENT MOTIVATIONAL INTERVIEWING, DENTAL CASE MANAGEMENT PATIENT EDUCATION TO IMPROVE ORAL HEALTH LITERACY, TELEDENTISTRY - SYNCHRONOUS; REAL-TIME ENCOUNTER, TELEDENTISTRY - ASYNCHRONOUS; INFORMATION STORED AND FORWARDED TO DENTIST FOR SUBSEQUENT REVIEW, DENTAL CASE MANAGEMENT - PATIENTS WITH SPECIAL HEALTH CARE NEEDS, UNSPECIFIED ADJUNCTIVE PROCEDURE, BY REPORT, ANCILLARY DENTAL SERVICE (PRI BUS ONLY - INTERNAL USE), INELIGIBLE DENTAL SERVICE (PRI BUS - INTERNAL USE ONLY), ANCILLARY DENTAL SERVICE (PACHIP FQHC INTERNAL USE), VISION SERVICE ACCUMULATOR - FOR INTERNAL USE ONLY, RX SERVICE ACCUMULATOR - FOR INTERNAL USE ONLY, MED SURG SERVICE ACCUMULATOR - FOR INTERNAL USE ONLY. United Concordia is an independent company providing administrative services for Blue Cross Blue Shield of Wyoming members and providers. A full-color guide to dental implantation and restoration. A full-color guide to dental implantation and restoration. This comprehensive work covers the various aspects of modern implant practice using laterally inserted implants. ), PULPAL REGENERATION - INTERIM MEDICATION REPLACEMENT, PULPAL REGENERATION - COMPLETION OF TREATMENT, PERIRADICULAR SURGERY WITHOUT APICOECTOMY, BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY - PER TOOTH, SINGLE SITE, BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY - EACH ADDITIONAL CONTIGUOUS TOOTH IN THE SAME SURGICAL SITE, BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATION IN CONJUNCTION WITH PERIRADICULAR SURGERY, GUIDED TISSUE REGENERATION, RESORBABLE BARRIER, PER SITE, IN CONJUNCTION WITH PERIRADICULAR SURGERY, INTENTIONAL REIMPLANTATION (INCLUDING NECESSARY SPLINTING), SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM, HEMISECTION (INCLUDING ANY ROOT REMOVAL) NOT INCLUDING ROOT CANAL THERAPY, CANAL PREPARATION AND FITTING OF PREFORMED DOWEL OR POST, UNSPECIFIED ENDODONTIC PROCEDURE (BY REPORT), GINGIVECTOMY OR GINGIVOPLASTY - FOUR OR MORE CONTIGUOUS TEETH OR TOOTH BOUNDED SPACES PER QUADRANT, GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE CONTIGUOUS TEETH OR TOOTH BOUNDED SPACES PER QUADRANT, GINGIVECTOMY OR GINGIVOPLASTY TO ALLOW ACCESS FOR RESTORATIVE PROCEDURE, PER TOOTH, ANATOMICAL CROWN EXPOSURE - FOUR OR MORE CONTIGUOUS TEETH OR TOOTH BOUNDED SPACES PER QUADRANT, ANATOMICAL CROWN EXPOSURE - ONE TO THREE TEETH OR TOOTH BOUNDED SPACES PER QUADRANT, GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - FOUR OR MORE CONTIGUOUS TEETH OR TOOTH BOUNDED SPACES PER QUADRANT, GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - ONE TO THREE CONTIGUOUS TEETH OR TOOTH BOUNDED SPACES PER QUADRANT, OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AND CLOSURE) - FOUR OR MORE CONTIGUOUS TEETH OR TOOTH BOUNDED SPACES PER QUADRANT, OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AND CLOSURE) - ONE TO THREE CONTIGUOUS TEETH OR TOOTH BOUNDED SPACES PER QUADRANT, BONE REPLACEMENT GRAFT - RETAINED NATURAL TOOTH - FIRST SITE IN QUADRANT, BONE REPLACEMENT GRAFT - RETAINED NATURAL TOOTH - EACH ADDITIONAL SITE IN QUADRANT, BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATION, GUIDED TISSUE REGENERATION - RESORBABLE BARRIER, PER SITE, GUIDED TISSUE REGENERATION - NONRESORBABLE BARRIER, PER SITE, (INCLUDES MEMBRANE REMOVAL), AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AND RECIPIENT SURGICAL SITES) FIRST TOOTH, IMPLANT, OR EDENTULOUS TOOTH POSITION IN GRAFT, MESIAL/DISTAL WEDGE PROCEDURE, SINGLE TOOTH (WHEN NOT PERFORMED IN CONJUNCTION WITH SURGICAL PROCEDURES IN THE SAME ANATOMICAL AREA), NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT (INCLUDING RECIPIENT SITE AND DONOR MATERIAL) FIRST TOOTH, IMPLANT, OR EDENTULOUS TOOTH POSITION IN GRAFT, COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT, PER TOOTH, FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR SURGICAL SITES) FIRST TOOTH, IMPLANT, OR EDENTULOUS TOOTH POSITION IN GRAFT, FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR SURGICAL SITES) EACH ADDITIONAL CONTIGUOUS TOOTH, IMPLANT, OR EDENTULOUS TOOTH POSITION IN SAME GRAFT SITE, AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AND RECIPIENT SURGICAL SITES) - EACH ADDITIONAL CONTIGUOUS TOOTH, IMPLANT OR EDENTULOUS TOOTH POSITION IN SAME GRAFT SITE, NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT SURGICAL SITE AND DONOR MATERIAL) - EACH ADDITIONAL CONTIGUOUS TOOTH, IMPLANT, OR EDENTULOUS TOOTH POSITION IN SAME GRAFT SITE, PERIODONTAL SCALING AND ROOT PLANING - FOUR OR MORE TEETH PER QUADRANT, PERIODONTAL SCALING AND ROOT PLANING - ONE TO THREE TEETH PER QUADRANT, SCALING IN PRESENCE OF GENERALIZED MODERATE OR SEVERE GINGIVAL INFLAMMATION FULL MOUTH, AFTER ORAL EVALUATION, FULL MOUTH DEBRIDEMENT TO ENABLE A COMPREHENSIVE ORAL EVALUATION AND DIAGNOSIS ON A SUBSEQUENT VISIT, LOCALIZED DELIVERY OF ANTIMICROBIAL AGENTS VIA CONTROLLED RELEASE VEHICLE INTO DISEASED CREVICULAR TISSUE, PER TOOTH, UNSCHEDULED DRESSING CHANGE (BY SOMEONE OTHER THAN TREATING DENTIST OR THEIR STAFF), UNSPECIFIED PERIODONTAL PROCEDURE, BY REPORT, MAXILLARY PARTIAL DENTURE - RESIN BASE (INCLUDING ANY CONVENTIONAL CLASPS, RESTS AND TEETH), MANDIBULAR PARTIAL DENTURE - RESIN BASE (INCLUDING ANY CONVENTIONAL CLASPS, RESTS AND TEETH), MAXILLARY PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING RETENTIVE/CLASPING MATERIALS, RESTS AND TEETH), MANDIBULAR PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING RETENTIVE/CLASPING MATERIALS, RESTS AND TEETH), IMMEDIATE MAXILLARY PARTIAL DENTURE - RESIN BASE (INCLUDING RETENTIVE/CLASPING MATERIALS, RESTS AND TEETH), IMMEDIATE MANDIBULAR PARTIAL DENTURE - RESIN BASE (INCLUDING RETENTIVE/CLASPING MATERIALS, RESTS AND TEETH), IMMEDIATE MAXILLARY PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING RETENTIVE/CLASPING MATERIALS, RESTS AND TEETH), IMMEDIATE MANDIBULAR PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENTURE BASES (INCLUDING RETENTIVE/CLASPING MATERIALS, RESTS AND TEETH), MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS, RESTS AND TEETH), MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS, RESTS AND TEETH), REMOVABLE LOWER UNILATERAL PARTIAL - ONE DENTURE, ONE PIECE CAST METAL - PER, REMOVEABLE UNILATERAL PARTIAL DENTURE - ONE PIECE CAST METAL (INCLUDING CLASPS AND TEETH), MAXILLARY, REMOVEABLE UNILATERAL PARTIAL DENTURE - ONE PIECE CAST METAL (INCLUDING CLASPS AND TEETH), MANDIBULAR, REMOVABLE UNILATERAL PARTIAL DENTURE - ONE PIECE FLEXIBLE BASE (INCLUDING CLASPS AND TEETH) - PER QUADRANT, REMOVABLE UNILATERAL PARTIAL DENTURE - ONE PIECE RESIN (INCLUDING CLASPS AND TEETH) - PER QUADRANT, REPAIR BROKEN COMPLETE DENTURE BASE, MANDIBULAR, REPAIR BROKEN COMPLETE DENTURE BASE, MAXILLARY, REPLACE MISSING OR BROKEN TEETH - COMPLETE DENTURE (EACH TOOTH), REPAIR RESIN PARTIAL DENTURE BASE, MANDIBULAR, REPAIR RESIN PARTIAL DENTURE BASE, MAXILLARY, REPAIR CAST PARTIAL FRAMEWORK, MANDIBULAR, REPAIR OR REPLACE BROKEN RETENTIVE CLASPING MATERIALS - PER TOOTH, ADD CLASP TO EXISTING PARTIAL DENTURE - PER TOOTH, REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MAXILLARY), REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MANDIBULAR), RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE), RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE), RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE), RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE), RELINE COMPLETE MAXILLARY DENTURE (LABORATORY), RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY), RELINE MAXILLARY PARTIAL DENTURE (LABORATORY), RELINE MANDIBULAR PARTIAL DENTURE (LABORATORY), REPLACEMENT OF REPLACEABLE PART OF SEMI-PRECISION OR PRECISION ATTACHMENT (MALE OR FEMALE COMPONENT), MODIFICATION OF REMOVABLE PROSTHESIS FOLLOWING IMPLANT SURGERY, ADD METAL SUBSTRUCTURE TO ACYRLIC FULL DENTURE (PER ARCH), UNSPECIFIED REMOVABLE PROSTHODONTIC PROCEDURE, BY REPORT, MANDIBULAR RESECTION PROSTHESIS WITH GUIDE FLANGE, MANDIBULAR RESECTION PROSTHESIS WITHOUT GUIDE FLANGE, TRISMUS APPLIANCE (NOT FOR TMD TREATMENT), VESICULOBULLOUS DISEASE MEDICAMENT CARRIER, ADJUST MAXILLOFACIAL PROSTHETIC APPLIANCE, BY REPORT, MAINTENANCE AND CLEANING OF A MAXILLOFACIAL PROSTHESIS (EXTRA OR INTRAORAL) OTHER THAN REQUIRED ADJUSTMENTS, BY REPORT, PERIODONTAL MEDICAMENT CARRIER WITH PERIPHERAL SEAL - LABORATORY PROCESSED, UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT, SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT, SURGICAL PLACEMENT OF INTERIM IMPLANT BODY FOR TRANSITIONAL PROSTHESIS: ENDOSTEAL IMPLANT, CONNECTING BAR - IMPLANT SUPPORTED OR ABUTMENT SUPPORTED, PREFABRICATED ABUTMENT - INCLUDES MODIFICATION AND PLACEMENT, CUSTOM FABRICATED ABUTMENT - INCLUDES PLACEMENT, ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN, ABUTMENT SUPPORTED PROCELAIN/CERAMIC CROWN, ABUTMENT SUPPORTED PROCELAIN FUSED TO METAL CROWN (PREDOMINANTLY BASE METAL), ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (NOBLE METAL), ABUTMENT SUPPORTED CAST METAL CROWN (HIGH NOBLE METAL), ABUTMENT SUPPORTED CAST METAL CROWN (PREDOMINANTLY BASE METAL), ABUTMENT SUPPORTED CAST METAL CROWN (NOBLE METAL), IMPLANT SUPPORTED PROCELAIN/CERAMIC CROWN, IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO HIGH NOBLE ALLOYS, IMPLANT SUPPORTED CROWN - HIGH NOBLE ALLOYS, ABUTMENT SUPPORTED RETAINER FOR PROCELAIN/CERAMIC FPD, ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (HIGH NOBLE METAL), ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (PREDOMINANTLY BASE METAL), ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (NOBLE METAL), ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (HIGH NOBLE METAL), ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (PREDOMINANTLY BASE METAL), ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (NOBLE METAL), IMPLANT SUPPORTED RETAINER FOR CERAMIC FPD, IMPLANT SUPPORTED RETAINER FOR FPD - PORCELAIN FUSED TO HIGH NOBLE ALLOYS, IMPLANT SUPPORTED RETAINER FOR METAL FPD - HIGH NOBLE ALLOYS, IMPLANT MAINTENANCE PROCEDURES WHEN PROSTHESES ARE REMOVED AND REINSERTED, INCLUDING CLEANSING OF PROSTHESES AND ABUTMENTS, SCALING AND DEBRIDEMENT IN THE PRESENCE OF INFLAMMATION OR MUCOSITIS OF A SINGLE IMPLANT, INCLUDING CLEANING OF THE IMPLANT SURFACES, WITHOUT FLAP ENTRY AND CLOSURE, IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE ALLOYS, IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO NOBLE ALLOYS, IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS, IMPLANT SUPPORTED CROWN - PREDOMINANTLY BASE ALLOYS, IMPLANT SUPPORTED CROWN - TITANIUM AND TITANIUM ALLOYS, REPAIR IMPLANT SUPPORTED PROSTHESIS, BY REPORT, REPLACEMENT OF SEMI-PRECISION OR PRECISION ATTACHMENT (MALE OR FEMALE COMPONENT) OF IMPLANT/ABUTMENT SUPPORTED PROSTHESIS, PER ATTACHMENT, RE-CEMENT OR RE-BOND IMPLANT/ABUTMENT SUPPORTED CROWN, RE-CEMENT OR RE-BOND IMPLANT/ABUTMENT SUPPORTED FIXED PARTIAL DENTURE, ABUTMENT SUPPORTED CROWN - TITANIUM AND TITANIUM ALLOYS, ABUTMENT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS, IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO PREDOMINANTLY BASE ALLOYS, IMPLANT SUPPORTED RETAINER FOR FPD - PORCELAIN FUSED TO NOBLE ALLOYS, DEBRIDEMENT OF A PERIIMPLANT DEFECT OR DEFECTS SURROUNDING A SINGLE IMPLANT, AND SURFACE CLEANING OF THE EXPOSED IMPLANT SURFACES, INCLUDING FLAP ENTRY AND CLOSURE, DEBRIDEMENT AND OSSEOUS CONTOURING OF A PERIIMPLANT DEFECT OR DEFECTS SURROUNDING A SINGLE IMPLANT, AND INCLUDES SURFACE CLEANING OF THE EXPOSED IMPLANT SURFACES, INCLUDING FLAP ENTRY AND CLOSURE, BONE GRAFT FOR REPAIR OF PERI-IMPLANT DEFECT - DOES NOT INCLUDE FLAP ENTRY AND CLOSURE, IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARCH - MAXILLARY, IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARCH - MANDIBULAR, IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDENTULOUS ARCH - MAXILLARY, IMPLANT/ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDENTULOUS ARCH - MANDIBULAR, IMPLANT/ABUTMENT SUPPORTED FIXED DENTURE FOR EDENTULOUS ARCH - MAXILLARY, IMPLANT/ABUTMENT SUPPORTED FIXED DENTURE FOR EDENTULOUS ARCH - MANDIBULAR, IMPLANT/ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULOUS ARCH - MAXILLARY, IMPLANT/ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULOUS ARCH - MANDIBULAR, IMPLANT/ABUTMENT SUPPORTED INTERIM FIXED DENTURE FOR EDENTULOUS ARCH - MANDIBULAR, IMPLANT/ABUTMENT SUPPORTED INTERIM FIXED DENTURE FOR EDENTULOUS ARCH - MAXILLARY, IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS, IMPLANT SUPPORTED RETAINER FOR METAL FPD - PREDOMINANTLY BASE ALLOYS, IMPLANT SUPPORTED RETAINER FOR METAL FPD - NOBLE ALLOYS, IMPLANT SUPPORTED RETAINER FOR METAL FPD - TITANIUM AND TITANIUM ALLOYS, RADIOGRAPHIC/SURGICAL IMPLANT INDEX, BY REPORT, ABUTMENT SUPPORTED RETAINER CROWN FOR FPD - TITANIUM AND TITANIUM ALLOYS, ABUTMENT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS, PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL, PONTIC - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL, PONTIC - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS, PONTIC - RESIN WITH PREDOMINANTLY BASE METAL, PROVISIONAL PONTIC- FURTHER TREATMENT OR COMPLETION OF DIAGNOSIS NECESSARY PRIOR TO FINAL IMPRESSION, RETAINER - CAST METAL FOR RESIN BONDED FIXED PROSTHESIS, RETAINER - PORCELAIN/CERAMIC FOR RESIN BONDED FIXED PROSTHESIS, RESIN RETAINER - FOR RESIN BONDED FIXED PROSTHESIS, RETAINER INLAY - PORCELAIN/CERAMIC, TWO SURFACES, RETAINER INLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES, RETAINER INLAY - CAST HIGH NOBLE METAL, TWO SURFACES, RETAINER INLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES, RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES, RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SURFACES, RETAINER INLAY - CAST NOBLE METAL, TWO SURFACES, RETAINER INLAY - CAST NOBLE METAL, THREE OR MORE SURFACES, RETAINER ONLAY - PORCELAIN/CERAMIC, TWO SURFACES, RETAINER ONLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES, RETAINER ONLAY - CAST HIGH NOBLE METAL, TWO SURFACES, RETAINER ONLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES, RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES, RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SURFACES, RETAINER ONLAY - CAST NOBLE METAL, TWO SURFACES, RETAINER ONLAY - CAST NOBLE METAL, THREE OR MORE SURFACES, RETAINER CROWN - INDIRECT RESIN BASED COMPOSITE, RETAINER CROWN - RESIN WITH HIGH NOBLE METAL, RETAINER CROWN - RESIN WITH PREDOMINANTLY BASE METAL, RETAINER CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL, RETAINER CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL, RETAINER CROWN - PORCELAIN FUSED TO NOBLE METAL, RETAINER CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS, RETAINER CROWN -3/4 CAST HIGH NOBLE METAL, RETAINER CROWN - 3/4 CAST PREDOMINANTLY BASE METAL, RETAINER CROWN 3/4 - TITANIUM AND TITANIUM ALLOYS, RETAINER CROWN - FULL CAST HIGH NOBLE METAL, RETAINER CROWN - FULL CAST PREDOMINANTLY BASE METAL, PROVISIONAL RETAINER CROWN- FURTHER TREATMENT OR COMPLETION OF DIAGNOSIS NECESSARY PRIOR TO FINAL IMPRESSION, RETAINER CROWN - TITANIUM AND TITANIUM ALLOYS, RE-CEMENT OR RE-BOND FIXED PARTIAL DENTURE, FIXED PARTIAL DENTURE REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE, UNSPECIFIED FIXED PROSTHODONTIC PROCEDURE, BY REPORT, EXTRACTION, CORONAL REMNANTS - PRIMARY TOOTH, EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORCEPS REMOVAL), REMOVAL OF IMPACTED TOOTH - PARTIALLY BONY, REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY, REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY, WITH UNUSUAL SURGICAL COMPLICATIONS, REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE), CORONECTOMY - INTENTIONAL PARTIAL TOOTH REMOVAL, TOOTH REIMPLANTATION AND/OR STABILIZATION OF ACCIDENTALLY EVULSED OR DISPLACED TOOTH, TOOTH TRANSPLANTATION (INCLUDES REIMPLANTATION FROM ONE SITE TO ANOTHER AND SPLINTING AND/OR STABILIZATION), MOBILIZATION OF ERUPTED OR MALPOSITIONED TOOTH TO AID ERUPTION. 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