Browse HCPCS Level II 2020 Edition

D9910 - D9975  Adjunctive General Dental Services - Miscellaneous Services

D9910 Application of desensitizing medicament short Dent appl desensitizing med RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9911 Application of desensitizing resin for cervical and/or root surface, per tooth short Appl desensitizing resin RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9920 Behavior management, by report short Behavior management RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9930 treatment of complications (post-surgical) - unusual circumstances, by report short Treatment of complications RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 YYY MUE Location Value Ajudication Indicator Rationale PRA 1.0 2 Date of Service Edit: Policy Code Descriptor / CPT Instruction OPH 1.0 2 Date of Service Edit: Policy Code Descriptor / CPT Instruction

D9932 Cleaning and inspection of removable complete denture, maxillary short Clean & inspect rem dent max RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9933 Cleaning and inspection of removable complete denture, mandibular short Clean & inspect rem dent man RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9934 Cleaning and inspection of removable partial denture, maxillary short Clean rem part denture max RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9935 Cleaning and inspection of removable partial denture, mandibular short Clean rem part denture mand RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9941 Fabrication of athletic mouthguard short Fabrication athletic guard RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9942 Repair and/or reline of occlusal guard short Repair/reline occlusal guard RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9943 Occlusal guard adjustment short Occlusal guard adjustment RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9944 Occlusal guard - hard appliance, full arch short Occ guard, hard, full arch RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 2.0 2 Date of Service Edit: Policy Anatomic Consideration

D9945 Occlusal guard - soft appliance, full arch short Occ guard, soft, full arch RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 2.0 2 Date of Service Edit: Policy Anatomic Consideration

D9946 Occlusal guard - hard appliance, partial arch short Occ guard, hard, part arch RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 2.0 2 Date of Service Edit: Policy Anatomic Consideration

D9950 Occlusion analysis-mounted case short Occlusion analysis RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 YYY MUE Location Value Ajudication Indicator Rationale PRA 1.0 3 Date of Service Edit: Clinical Nature of Service/Procedure OPH 1.0 3 Date of Service Edit: Clinical Nature of Service/Procedure

D9951 Occlusal adjustment-limited short Limited occlusal adjustment RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 YYY MUE Location Value Ajudication Indicator Rationale PRA 1.0 3 Date of Service Edit: Clinical Nature of Service/Procedure OPH 1.0 3 Date of Service Edit: Clinical Nature of Service/Procedure

D9952 Occlusal adjustment-complete short Complete occlusal adjustment RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 YYY MUE Location Value Ajudication Indicator Rationale PRA 1.0 3 Date of Service Edit: Clinical Nature of Service/Procedure OPH 1.0 3 Date of Service Edit: Clinical Nature of Service/Procedure

D9961 Duplicate/copy patient's records short Dup/copy patient's records RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 0.0 3 Date of Service Edit: Clinical CMS Policy

D9970 Enamel microabrasion short Enamel microabrasion RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9971 Odontoplasty 1 - 2 teeth; includes removal of enamel projections short Odontoplasty 1-2 teeth RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9972 External bleaching - per arch - performed in office short Extrnl bleaching per arch RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9973 External bleaching - per tooth short Extrnl bleaching per tooth RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9974 Internal bleaching - per tooth short Intrnl bleaching per tooth RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX

D9975 External bleaching for home application, per arch; includes materials and fabrication of custom trays short External bleaching home app RVU CPT Modifier Physician Component Facility Practice Nonfacility Practice Professional Liability Insurance Total Facility Total Nonfacility Global Period 0.0 0.0 0.0 0.0 0.0 0.0 XXX