Most common D9069 code reviews : HbA1c in-office, point-of-service testing - 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).
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.
Procedure in D9069 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.
In lieu of surgery, the formation of a pathway to achieve an apical seal without surgical intervention ecause of a non-negotiable root canal blocked by foreign bodies,D9069 included but not limited to separated instruments, broken posts or alcification of 50% or more of the roots.
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.
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