Guide to the Child Dental Benefits Schedule



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Periodontics


88213 Treatment of acute periodontal infection – per visit

88221 Clinical periodontal analysis and recording

Item

Service

Benefit ($)

88213
Treatment of acute periodontal infection – per visit

This item describes the treatment of acute periodontal infection(s). It may include establishing drainage and the removal of calculus from the affected tooth (teeth). Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

Limit of two (2) per 12 month period.

A benefit does not apply if a benefit has been paid for item 88415 on the same tooth on the same day.


69.70
88221
Clinical periodontal analysis and recording

This is a special examination performed as part of the diagnosis and management of periodontal disease. The procedure consists of assessing and recording a patient's periodontal condition. All teeth and six sites per tooth must be recorded. Written documentation of these measurements must be retained.
Applicable restrictions

Limit of one (1) per 24 month period.
52.95

Oral Surgery


88311 Removal of a tooth or part(s) thereof – first tooth extracted on a day

88314 Sectional removal of a tooth or part(s) thereof – first tooth extracted on a day

88316 Additional extraction requiring removal of a tooth or part(s) thereof, or sectional removal of a tooth

88322 Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division – first tooth extracted on a day

88323 Surgical removal of a tooth or tooth fragment requiring removal of bone – first tooth extracted on a day

88324 Surgical removal of a tooth or tooth fragment requiring both removal of bone and tooth division – first tooth extracted on a day

88326 Additional extraction requiring surgical removal of a tooth or tooth fragment

88351 Repair of skin and subcutaneous tissue or mucous membrane

88384 Repositioning of displaced tooth/teeth – per tooth

88386 Splinting of displaced tooth/teeth – per tooth

88387 Replantation and splinting of a tooth

88392 Drainage of abscess

Item

Service – Extractions

Benefit ($)

88311
Removal of a tooth or part(s) thereof – first tooth extracted on a day

A procedure consisting of the removal of a tooth or part(s) thereof. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

Limit of one (1) per day. For additional extractions on the same day, use item 88316.

A benefit does not apply if a benefit has been paid for item 88314 on the same day.

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.

131.30
88314
Sectional removal of a tooth or part(s) thereof – first tooth extracted on a day

The removal of a tooth or part(s) thereof in sections. Bone removal may be necessary. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

Limit of one (1) per day. For additional extractions on the same day, use item 88316.

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.


167.80
88316
Additional extraction requiring removal of a tooth or part(s) thereof, or sectional removal of a tooth

Additional extraction provided on the same day as a service described in item 88311 or 88314 is provided to the patient.
Applicable restrictions

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.
82.75



Item

Service – Surgical Extractions

Benefit ($)

88322
Surgical removal of a tooth or tooth fragment not requiring removal of bone or tooth division – first tooth extracted on a day

Removal of a tooth or tooth fragment where an incision and the raising of a mucoperiosteal flap is required, but where removal of bone or sectioning of the tooth is not necessary to remove the tooth. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

Limit of one (1) per day. For additional extractions on the same day, use item 88326.

A benefit does not apply if a benefit has been paid for item 88323 or 88324 on the same day.

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.

213.10
88323
Surgical removal of a tooth or tooth fragment requiring removal of bone – first tooth extracted on a day

Removal of a tooth or tooth fragment where removal of bone is required after an incision and a mucoperiosteal flap raised. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

Limit of one (1) per day. For additional extractions on the same day, use item 88326.

A benefit does not apply if a benefit has been paid for item 88324 on the same day.

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.

243.35
88324
Surgical removal of a tooth or tooth fragment requiring both removal of bone and tooth division – first tooth extracted on a day

Removal of a tooth or tooth fragment where both removal of bone and sectioning of the tooth are required after an incision and a mucoperiosteal flap raised. The tooth will be removed in portions. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

Limit of one (1) per day. For additional extractions on the same day, use item 88326.

A benefit only applies if performed on multi-rooted teeth.



A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.
327.35
88326
Additional extraction requiring surgical removal of a tooth or tooth fragment

Additional surgical extraction provided on the same day as a service described in item 88322, 88323 or 88324 is provided to the patient.
Applicable restrictions

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.
174.35



Item

Service – Treatment of Maxillo-facial injuries

Benefit ($)

88351
Repair of skin and subcutaneous tissue or mucous membrane

The surgical cleaning and repair of a facial skin wound in the region of the mouth or jaws, or the repair of oral mucous membrane, where the wounds involve the subcutaneous tissues. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

A benefit only applies if the service is provided on the same day of a service under item 88384, 88386 or 88387.
159.95



Item

Service – Other Surgical Procedures

Benefit ($)

88384
Repositioning of displaced tooth/teeth – per tooth

A procedure following trauma where the position of the displaced tooth/teeth is corrected by manipulation. Stabilising procedures are itemised separately. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.
190.85
88386
Splinting of displaced tooth/teeth – per tooth

A procedure following trauma where the position of the displaced tooth/teeth may be stabilized by splinting. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.
196.90
88387
Replantation and splinting of a tooth

Replantation of a tooth which has been avulsed or intentionally removed. It may be held in the correct position by splinting. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.
385.55
88392
Drainage of abscess

Drainage and/or irrigation of an abscess other than through a root canal or at the time of extraction. The drainage may be through an incision or inserted tube. Inclusive of the insertion of sutures, normal post-operative care and suture removal.
Applicable restrictions

A benefit does not apply if a benefit has been paid for an extraction service on the same tooth.
96.85



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