Most common D4649 code reviews : , Scaling in the presence of generalized moderate or severe gingival inflammation - full mouth, after oral valuation or Intravenous moderate (conscious) sedation analgesia - first 30 minutes.
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.
This code is used to report evaluation of periodontal conditions, probing and charting, evaluation and recording of new or established patients` dental and medical history and general health assessment.With D4649 Patients showing signs or symptoms of periodontal disease and patients with risk factors such as smoking or diabetes would require comprehensive periodontal evaluation. This may also include evaluation and recording of dental caries, missing or unerupted teeth, restorations, occlusal relationships and oral cancer evaluation. This code should not be used along with a comprehensive oral evaluation (D4649) by the same dentist on the same visit.
A patient presents to your office with a buccal space abscess in the upper left quadrant eliminating the nasolabial fold The tooth has no history of previous trauma Clinical evaluation reveals a large resin with recurrent caries Endodontic testing is performed and tooth #10 is necrotic and severely responsive to percussion A periapical radiograph is taken and a 4mm x 5mm periapical lesion of endodontic origin is visualized. Palpation reveals a fluctuant buccal swelling centered apically to tooth #10. Incision and drainage performed with a drain sutured into place Endodontic treatment or retreatment can be initiated and calcium hydroxide placed Any additional treatments should be coded appropriately.
Core build up, including pins when required - refers to building up of coronal structure when there is insufficient retention for a separate extracoronal restorative procedure. A core buildup is not a filler to eliminate any undercut, box form or concave irregularity in a preparation. The fees for buildups not required for retention are Disallowed.