Northeast Delta Dental Abbreviation Key

Download Northeast Delta Dental Abbreviation Key

Preview text

Northeast Delta Dental

Abbreviation Key

& / 1/12 mos 1/24 mos 1/36 mos 1/48 mos 1/60 mos 1/benefit yr 1/cal yr 1/lifetime 1/yr 1st & 2nd 2/24 mos 2/6 mos 2/60 mos 2/cal yr 2/lifetime 3/cal yrs accum add adj adj denture antimicro agents
appl as needed b/up brux appl BWX

and or 1 in 12 months 1 in 24 months 1 in 36 months 1 in 48 months 1 in 60 months 1 in a benefit year 1 in a calendar year 1 in a lifetime 1 in a year first and second 2 in 24 months 2 in 6 months 2 in 60 months 2 in a calendar year 2 in a lifetime 3 in a calendar year accumulation adding adjustment full or partial denture adjustment localized delivery of antimicrobial agents via a controlled release vehicle appliance as needed or as necessary build up bruxism appliance bitewing x-ray and/or vertical bitewings bitewing/extra-oral xrays

cal yr cal yrs cks against comp eval consult consult-special cov crn crns crn leng debride denture adj diag casts endo eval excl ext exts FL2 FM debride FMX FPD GA
habit appl hrs impac incl LTD prob focus major max

calendar year

calendar years

checks against

comprehensive oral evaluation


consultation with a specialist




crown lengthening


denture adjustment

diagnostic casts







full mouth debridement

full mouth series x-rays

fixed partial denture/bridge

general anesthesia and deep sedation

habit appliance


impaction, impacted


limited problem focus

major restorative procedure



medically nec min age 14 mo mos not cov no ck against occl occl adj occl gd occl gd & adj oral CA screen ortho OS oss per site p/tth palliative panx PAs PAs/Occl/extra oral as needed pathology p/quad perio perio m perio m following active perio Tx
post comp pre-d pre-ds preserv Prev primary

if medically necessary up to minimum age 14 month months not covered does not check against occlusal occlusal adjustment occlusal guards occlusal guards and adjustments oral cancer screening orthodontic oral surgery osseous per site per tooth palliative treatment Panorex periapical x-rays periapical, occlusal and extra oral x-rays as needed histopathologic evaluation per quadrant periodontal periodontal maintenance periodontal maintenance following active periodontal therapy posterior composite predetermination predeterminations preservation diagnostic and preventive primary

prophy/perio m
prosth pulp test quad RCT rebase dentures & partials rebase & reline rebase & repairs Re-c Re-c crn Re-c inlay removal scale/giv inflam
seal silver & white (anterior) fillings 2/cal yr per surf per tth spc maint SR+P SS Crn sub surf p/tth surg ext-bone removal
interim dentures interim partials thru tth Tx unrest w/

prophylaxis or periodontal maintenance prosthetic pulp vitality test quadrant root canal treatment rebase full and partial denture
rebase and reline rebase and repairs recementation recementation of a crown recementation of an inlay removal scaling in presence of gingival inflammation sealant(s) amalgam and composite restorations are covered twice per calendar year per surface per tooth space maintainer scaling and root planing stainless steel crown subscriber surface per tooth surgical surgical and removal of impacted teeth temporary or partial dentures Interim partial dentures through tooth treatment unrestored with

Preparing to load PDF file. please wait...

0 of 0
Northeast Delta Dental Abbreviation Key