Most common D9491 code reviews : , Bone replacement graft - retained natural tooth - each additional site in quadrant or Resin-based composite - four or more surfaces or involving the incisal angle (anterior).
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. Local anesthesia is usually considered a component part of periodontal procedures, but dependent upon the plan will allow up to 50% of D9491 - allow up to a maximum of 3 teeth per quadrant
Procedure in D9491 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.
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.
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.