D5211-D5214 Removable partial dentures FMX and/or Pano Complete missing tooth chart Treatment plan D5410-D5422 Adjustments to dentures If > 3 per denture/year Narrative D5510-D5671 Repairs to complete and Narrative partial dentures D5710-D5761 Denture rebase/relines If > 1 per denture/year Narrative D5862 Precision attachment Narrative D5867 Replacement of a component of precision attachment PROSTHODONTICS, FIXED D6200 - D6999 D6205-D6254 Fixed partial denture pontics PA and/or FMX and/or Pano D6545-D6795 Fixed partial denture identify all missing teeth in retainers both arches. Use tooth chart if available on claim form D6975 Coping PA D6970 Other fixed partial denture These codes were deleted in CDT PA D6972 services 2013 D6976 D6977 D6980 Fixed partial denture repair Narrative necessitated by Restorative material failure D6999 Unspecified fixed Narrative prosthodontic procedure by report ORAL SURGERY D7000 - D7999 D7111 Extraction coronal remnants Prior-authorization only if PA deciduous tooth primary teeth near exfoliation D7140 Extraction erupted tooth Tooth #s A, B, C, H, I, J, K, L, M, R, S, or T and 9 years old ≥ OR Tooth #s D, E, F, G, N, O, P, or Q and years old ≥ 6 D7210-D7240 Surgical removal of erupted PA and/or Pano tooth and removal of Narrative (reasons for impacted teeth removal) D7241 Removal of impacted tooth PA and/or Pano completely bony with Narrative (reasons for removal unusual surgical and describe unusual complications complications D7250 Surgical removal of residual PA and/or Pano root (cutting procedure) Narrative D7310-D7340 Alveoloplasty PA and/or FMX and/or Pano Vestibuloplasty (if in conjunction with extractions) and Narrative D7471-D7485 Tori removal Narrative Reduction of osseous tuberosity D7510 Incision and drainage of Narrative abscess intraoral
D5211-D5214 Removable partial dentures FMX and/or Pano Complete missing tooth chart Treatment plan D5410-D5422 Adjustments to dentures If > 3 per denture/year Narrative D5510-D5671 Repairs to complete and partial dentures Narrative D5710-D5761 Denture rebase/relines If > 1 per denture/year Narrative D5862 D5867 Precision attachment Replacement of a component of precision attachment Narrative PROSTHODONTICS, FIXED D6200 - D6999 D6205-D6254 D6545-D6795 Fixed partial denture pontics Fixed partial denture retainers PA and/or FMX and/or Pano identify all missing teeth in both arches. Use tooth chart if available on claim form D6975 Coping PA D6970 D6972 D6976 D6977 Other fixed partial denture services These codes were deleted in CDT 2013 PA D6980 Fixed partial denture repair necessitated by Restorative material failure Narrative D6999 Unspecified fixed prosthodontic procedure by report Narrative ORAL SURGERY D7000 - D7999 D7111 D7140 Extraction coronal remnants deciduous tooth Extraction erupted tooth Prior-authorization only if primary teeth near exfoliation Tooth #s A, B, C, H, I, J, K, L, M, R, S, or T and ≥ 9 years old OR Tooth #s D, E, F, G, N, O, P, or Q and ≥ 6 years old PA D7210-D7240 Surgical removal of erupted tooth and removal of impacted teeth PA and/or Pano Narrative (reasons for removal) D7241 Removal of impacted tooth completely bony with unusual surgical complications PA and/or Pano Narrative (reasons for removal and describe unusual complications D7250 Surgical removal of residual root (cutting procedure) PA and/or Pano Narrative D7310-D7340 Alveoloplasty Vestibuloplasty PA and/or FMX and/or Pano (if in conjunction with extractions) and Narrative D7471-D7485 Tori removal Reduction of osseous tuberosity Narrative D7510 Incision and drainage of abscess intraoral Narrative