Code

Procedure description

DM/+L

MP

TC

General Dental Practice

(054)

Maxillo-facial and Oral Surgery

(062)

Prosthodontics

(094)

J.  ORAL AND MAXILLOFACIAL SURGERY

Refer to the specialist maxillo-facial and oral surgeon schedule for surgical services not listed in this schedule.

EXTRACTIONS

8201

Extraction - tooth or exposed tooth roots (first per quadrant)

T

B

198.24

297.37

-

The removal of an erupted tooth or exposed tooth roots by means of elevators and/or forceps. This includes the routine removal of tooth structure and suturing when necessary. Report per tooth. The removal of more than one exposed root of the same tooth should be reported as one extraction. When a normal extraction fails and residual tooth roots are surgically removed during the same visit, tariff code 8937 should be reported.

8202

Extraction - each additional tooth or exposed tooth roots

T

B

90.95

136.42

-

To be reported for an additional extraction in the same quadrant at the same visit.

SURGICAL EXTRACTIONS (includes routine postoperative care)

8213

Surgical removal of residual tooth roots (cutting procedure) includes cutting of gingiva and bone, removal of tooth structure and closure.

T

S

879.23

-

-

This procedure requires mucoperiosteal flap elevation with bone removal, removal of tooth roots and closure. Report per tooth. The removal of more than one root of the same tooth should be reported as one surgical removal. A residual root is defined as the remaining root structure following the loss of the major portion (over 75%) of the crown.

8214

Surgical removal of residual tooth roots (cutting prcedure), each subsequent tooth

T

S

623.12

-

-

8937

Surgical removal of tooth

T

S

598.56

897.79

-

Surgical removal of erupted tooth requiring elevation of mucoperiosteal flap, removal of bone and/or other section of tooth.

Includes cutting of gingiva and bone, removal of tooth structure and closure. Tariff code 8220 is applicable when suture material is provided by the practitioner (Rule 013)

8953

Surgical removal of residual roots roots (cutting procedure) includes cutting of gingiva and bone, removal of tooth structure and closure.

T

S

-

1291.01

-

DISTRACTION OSTEOGENESIS

9067

Distraction of the alveolar ridge across one to two tooth sites

T

3272.60

4908.80

-

9068

Distraction of the alveolar ridge-across three to five tooth sites

T

3272.60

4908.80

-

9070

Distraction of the alveolar ridge-full arch

M

3272.60

4908.80

-

9073

Distraction for the reconstruction of the mandibular body (per side)

3272.60

4908.80

-

9078

Distraction for the reconstruction of the mandibular condyle and tempero-mandibular joint

3272.60

4908.80

-

9080

Distraction for the reconstruction of the midface (internal distractor)

3272.60

4908.80

-

9082

Distraction for the reconstruction of the midface (external distractor)

3272.60

4908.80

-

9084

Removal of an internal or external distractor device

628.70

843.20

-