Guide to the Child Dental Benefits Schedule



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Endodontics


88411 Direct pulp capping

88412 Incomplete endodontic therapy (tooth not suitable for further treatment)

88414 Pulpotomy

88415 Complete chemo-mechanical preparation of root canal – one canal

88416 Complete chemo-mechanical preparation of root canal – each additional canal

88417 Root canal obturation – one canal

88418 Root canal obturation – each additional canal

88419 Extirpation of pulp or debridement of root canal(s) – emergency or palliative

88421 Resorbable root canal filling – primary tooth

88455 Additional visit for irrigation and/or dressing of the root canal system – per tooth

88458 Interim therapeutic root filling – per tooth

Item

Service – Pulp and Root Canal Treatments

Benefit ($)

88411
Direct pulp capping

A procedure where an exposed pulp is directly covered with a protective dressing or cement.
Applicable restrictions

A benefit does not apply if the service is provided within 3 months of a service under item 88458.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.


34.85
88412
Incomplete endodontic therapy (tooth not suitable for further treatment)

A procedure where in assessing the suitability of a tooth for endodontic treatment a decision is made that the tooth is not suitable for restoration.
Applicable restrictions

Limit of one (1) per tooth.
119.40
88414
Pulpotomy

Amputation within the pulp chamber of part of the vital pulp of a tooth. The pulp remaining in the canal(s) is then covered with a protective dressing or cement.
Applicable restrictions

A benefit does not apply if a benefit has been paid for item 88421 on the same tooth on the same day.

A benefit does not apply if the service is provided within 3 months of a service under item 88458.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.

76.05
88415
Complete chemo-mechanical preparation of root canal – one canal

Complete chemo-mechanical preparation including removal of pulp or necrotic debris from a canal.
Applicable restrictions

Limit of one (1) per tooth per day.

A benefit does not apply if the service is provided within 3 months of a service under item 88458 unless on same day.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.

214.15
88416
Complete chemo-mechanical preparation of root canal – each additional canal

Complete chemo-mechanical preparation including removal of pulp or necrotic debris from each additional canal of a tooth with multiple canals.
Applicable restrictions

Limit of two (2) per tooth per day.

A benefit does not apply if the service is provided within 3 months of a service under item 88458 unless on same day.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.

102.00
88417
Root canal obturation – one canal

The filling of a root canal, following chemo-mechanical preparation.
Applicable restrictions

Limit of one (1) per tooth per day.

A benefit does not apply if the service is provided within 3 months of a service under item 88458.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.

208.60
88418
Root canal obturation – each additional canal

The filling, following chemo-mechanical preparation, of each additional canal in a tooth with multiple canals.
Applicable restrictions

Limit of two (2) per tooth per day.

A benefit does not apply if a benefit has been paid for item 88419 on the same tooth on the same day.

A benefit does not apply if the service is provided within 3 months of a service under item 88458.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.


97.55
88419
Extirpation of pulp or debridement of root canal(s) – emergency or palliative

The partial or thorough removal of pulp and/or debris from the root canal system of a tooth. This is an emergency or palliative procedure distinct from visits for scheduled endodontic treatment.
Applicable restrictions

A benefit does not apply if a benefit has been paid for an extraction, metallic or adhesive restoration service or items 88411, 88415, 88416, 88417, 88421, 88455, 88458, on the same tooth on the same day.

A benefit does not apply if the service is provided within 3 months of a service under item 88458.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.

137.90
88421
Resorbable root canal filling – primary tooth

The placement of resorbable root canal filling material in a primary tooth.
Applicable restrictions

Limit of one (1) per tooth.

A benefit does not apply if a benefit has been paid for item 88414 on the same tooth on the same day.

A benefit does not apply if the service is provided within 3 months of a service under item 88458.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.


119.40



Item

Service – Other Endodontic Services

Benefit ($)

88455
Additional visit for irrigation and/or dressing of the root canal system – per tooth

Additional debridement irrigation and short-term dressing required where evidence of infection or inflammation persists following prior opening of the root canal and removal of its contents.
Applicable restrictions

A benefit does not apply if a benefit has been paid for item 88414, 88415, 88416, 88417, 88418 or 88421 on the same tooth on the same day.

A benefit only applies if the service is provided within 3 months of a service under item 88415 or 88416.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.

105.70
88458
Interim therapeutic root filling – per tooth

A procedure consisting of the insertion of a long-term provisional (temporary) root canal filling with therapeutic properties which facilitates healing/development of the root and periradicular tissues over an extended time.
Applicable restrictions

Limit of three (3) per 12 month period.

A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.


140.95
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