Most common D5921 code reviews : Onlay - resin-based composite - four or more surfaces, Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use or Accession of tissue, gross examination, preparation and transmission of written report.
Sealant-per tooth Sealants and/or Preventive Resin Restorations are Benefited once per tooth on the occlusal surface of permanent first and second molars for Patients through age fifteen (15). The teeth must be free from caries orrestorations on the occlusal surface. A sealant or preventive resin restoration done on the same date of service and on the same surface as a restoration is considered a component of the restoration, and the fee for the sealant or preventive resin restoration is Disallowed.
Separation of one or more connections between abutments and/or pontics when some portion of a fixed rosthesis is to remain intact D5921 and serviceable following sectioning and extraction or other treatment Includes all recontouring and olishing of retained portions.
Removal of a portion of the pulp and D5921 application of a medicament with the aim of maintaining the vitality of the remaining portion to encourage continued physiological development andormation of the root. This procedure is not to be construed as the first stage of root canal therapy.
Sealant repair - per tooth - This procedure is disallowed when performed by the same dentist/dental office based on the same time limitation that exists for replacement of a sealant. It is allowed at 50% of D5921 when performed by a different provider or if after the time limitation for the same dentist.
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