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D0120 (fee involved)
periodic dental exam
D0150 (fee involved)
initial assessment- no perio
D0180 (fee involved)
initial assessment - perio
D0210 (fee involved)
complete series
D0220 (fee involved)
periapical film -1
D0230 (fee involved)
periapical - additional
D0272 (fee involved)
2 bitewings
D0274 (fee involved)
4 bitewings
D0330 (fee involved)
panoramic film
D0350
oral/ facial photos
D0470 (fee involved)
diagnostic casts
D0601
low caries risk
D0602
moderate caries risk
D0603
high caries risk
D0604
extreme caries risk (pseudo)
D1110 (fee involved)
adult prophylaxis
D1110.1 (fee involved)
adult prophylaxis (≤8 teeth)
D1120 (fee involved)
child prophylaxis
D1206 (fee involved)
varnish fluoride
D1208 (fee involved)
topical fluoride
D1310
nutritional counseling
D1320
initial tobacco questionnaire
D1320.1
tobacco counseling/ intervention
D1330
oral hygiene instruction
D1351 (fee involved)
sealant
D1353
sealant repair/ reseal
D4341 (fee involved)
quadrant scale/ debride
D4342 (fee involved)
scale/ debride 1-3 teeth
D4346 (fee involved)
generalized gingivitis scale
D4355 (fee involved)
full mouth debridement
D4381 (fee involved)
local delivery antimicrobial agent
D4910 (fee involved)
periodontal maintenance
D4910.1 (fee involved)
perio maintenance/ ≤8 teeth
D4921
subgingival irrigation
D6090 (fee involved)
replacement of implant part (o-ring)
D9430
dental visit for observation
D9630 (fee involved)
antibiotic premedication
D9910 (fee involved)
desensitization
D9932 (fee involved)
cleaning maxillary complete denture
D9933 (fee involved)
cleaning mandibular complete denture
D9975 (fee involved)
external bleaching - per arch
GV blacks class I
found in pits and grooves on occlusal of posteriors or on lingual of anteriors
GV blacks class II
affect proximal surfaces of posterior teeth
GV blacks class III
occur on proximal surfaces of anteriors, but not past incisal edge
GV blacks class IV
same as III but affect incisal edge
GV blacks class V
occur on cervical 3rd of buccal or lingual of any tooth
GV blacks class VI
occur on incisal edges of anteriors or cusp tips of posteriors