1 of 46 documents new jersey administrative code



Download 1.28 Mb.
Page13/14
Date conversion27.11.2016
Size1.28 Mb.
1   ...   6   7   8   9   10   11   12   13   14
§ 10:56-3.11 D8000-D8999 ORTHODONTICS
(a) Minor treatment for tooth guidance:

1. Includes all necessary adjustments.



2. Code may also be used for Orthodontic Retention Appliances following comprehensive treatment by a previous dentist.




Maximum Fee




HCPCS







Allowance

IND

Code

Mod

Procedure Description

S

$

NS




D8010




Limited orthodontic treatment of

595.00




590.00










the primary dentition













D8020




Limited orthodontic treatment of

595.00




590.00










the transitional dentition













D8030




Limited orthodontic treatment of

595.00




590.00










the adolescent dentition













D8040




Limited orthodontic treatment of

595.00




590.00










the adult dentition













D8050




Interceptive orthodontic treatment

595.00




590.00










of the primary dentition













D8060




Interceptive orthodontic treatment

595.00




590.00










of the transitional dentition










(b) Minor treatment to control harmful habits:

1. Includes all necessary adjustments.






D8210




Removable Appliance Therapy

595.00




590.00




D8220




Fixed Appliance Therapy

595.00




590.00

(c) Comprehensive orthodontic treatment--adolescent dentition:

1. Treatment of permanent dentition. Indicate anticipated time under treatment--maximum treatment reimbursable including retention--three years. Reimbursement for comprehensive orthodontic treatment will include removal and retention as required at no additional charge.






D8080




Comprehensive orthodontic

2,581




2,581










treatment of the adolescent



















dentition










(d) Other orthodontic services:




D8660




Pre-orthodontic treatment visit

11.00




10.00

NOTE 1: This code is to be used for comprehensive orthodontic evaluation and assessment.

NOTE 2: Definition and Criteria for Assessing Handicapping Malocclusion Permanent Dentition form (FD-10) must be available in patient records.






D8691




Repair of orthodontic appliance

49.50




45.00




D8692




Replacement of lost or broken

115.00




110.00










retainer










*

D8999




Unspecified Orthodontic Procedure,

BR




BR










By Report










NOTE: Complete description, diagnosis and treatment plan must be submitted.

45 of 46 DOCUMENTS


NEW JERSEY ADMINISTRATIVE CODE

Copyright © 2014 by the New Jersey Office of Administrative Law


*** This file includes all Regulations adopted and published through the ***

*** New Jersey Register, Vol. 46 No. 11, June 2, 2014 ***


TITLE 10. HUMAN SERVICES

CHAPTER 56. MANUAL FOR DENTAL SERVICES

SUBCHAPTER 3. HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS)
N.J.A.C. 10:56-3.12 (2014)
§ 10:56-3.12 D9000-D9999 ADJUNCTIVE GENERAL SERVICES
(a) Unclassified treatment:




Maximum Fee




HCPCS







Allowance

IND

Code

Mod

Procedure Description

S

$

NS

d

D9110




Palliative (Emergency) Treatment

10.00




9.00










of Dental Pain--Minor Procedures










NOTE: Emergency treatment of dental pain or infection, palliative (flat fee for all services performed, when not covered by separately listed procedure). Diagnosis and description of treatment is required. Per tooth or per site.

(b) Anesthesia:






D9210




Local Anesthesia Not in

13.00




11.00










Conjunction with Operative or



















Surgical Procedures










NOTE 1: Infiltration and/or nerve block for diagnostic purposes or purposes other than anesthesia.

NOTE 2: Complete report must be available in patient records.






D9211




Regional block anesthesia

13.00




11.00




D9212




Trigeminal division block

18.00




16.00










anesthesia













D9220

22

General Anesthesia

125.00




125.00

NOTE: This code applies when the dentist performing the services (attending dentist) also administers the general anesthesia or in conjunction with oral surgery services only.

(c) Special general anesthesia:

1. (Basic units--See American Society of Anesthesiologists Relative Value Guide--2000).




D9220




General anesthesia--first 30

22.00




22.00










minutes













D9221




General anesthesia--each

11.00




11.00










additional 15 minutes










NOTE 1: Time units are for each additional 15 minute period or major portion thereof limited to "table" or "chair" time only. Maximum reimbursable is two hours.

NOTE 2: The general anesthesia codes above are limited to use in restorative dentistry alone or restorative dentistry in conjunction with other dental services requiring anesthetic management. These codes are reimbursable only to the dentist whose sole function is to administer general anesthesia.



NOTE 3: An anesthesia record must be available which shows elapsed anesthesia time, and pinpoints time and amounts of drugs administered, pulse rate and character, blood pressure, respiration, and so forth.




D9230




Analgesia, anxiolysis, inhalation

15.00




14.00










of nitrous oxide













D9241




Intravenous sedation/

50.00




49.00










analgesia--first 30 minutes










NOTE: Parenteral Conscious Sedation.




D9242




Intravenous sedation/

11.00




11.00










analgesia--each additional 15



















minutes










NOTE: Maximum reimbursable is eight units.




D9248




Non-intravenous conscious sedation

40.00




40.00

(d) Professional consultation (diagnostic service provided by a dentist other than practitioner providing treatment):

1. A complete report must be available.



d

D9310




Consultation (diagnostic service

22.00




17.00










provided by dentist or physician



















other than practitioner providing



















treatment)










(e) Professional visits




D9410




House/extended care facility call

20.50




19.00




D9420




Hospital Call

32.00




27.00

NOTE: Code to be used for Hospital Day--Initial--Inpatient or Same Day Surgery.




D9420




Hospital Call

19.00




17.00

NOTE 1: Code to be used for Hospital Day--Subsequent.

NOTE 2: Consisting of care and treatment by the Practitioner subsequent to date of "Hospital Day--Initial" and including those procedures ordinarily performed during a hospital visit dependent upon the practitioner's discipline.

1   ...   6   7   8   9   10   11   12   13   14


The database is protected by copyright ©dentisty.org 2016
send message

    Main page