| | DIAGNOSTIC SERVICES |
| | |
| | Examinations |
| | 011 | Comprehensive oral examination |
| | 012 | Periodic oral examination |
| | 013 | Oral Examination - limited |
| | 014 | Consultation |
| | 015 | Consultation - extended (30 mins) |
| | 016 | Consultation by referral |
| | 017 | Consultation by referral - extended (30 minutes) |
| | 018 | Written report (not elsewhere included) |
| | 019 | Letter of referral incl. Specialist Referral |
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| | Radiological examination and interpretation |
| | 022 | Intraoral PA or B/W radiograph - per exposure |
| | 024 | Intraoral PA or B/W radiograph - each subs. Exposure (same day) |
| | 025 | Intraoral radiograph - occl, max or mand - per exposure |
| | 031 | Extraoral radiograph - max, mand - per exposure |
| | 033 | Lateral, ant-post, post-ant or subm-vertex radiograph of skull - per exposure |
| | 035 | Radiograph of TMJ - per exposure |
| | 036 | Ceph radiograph - lateral, ant-post, post-ant or subm-vertex - per exposure |
| | 037 | Panoramic radiograph - per exposure |
| | 038 | Hand-wrist radiograph for skeletal age assessment |
| | 039 | Tomography of the skull or parts thereof |
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| | Other diagnostic services |
| | 041 | Bacteriological examination |
| | 043 | Antibiotic sensitivity test |
| | 048 | Bacteriological screening test |
| | 051 | Biopsy of tissue |
| | 052 | Histopathological examination of tissue |
| | 053 | Cytological investigation |
| | 055 | Blood sample |
| | 061 | Pulp testing (part of examination) - per visit |
| | 071 | Diagnostic model - per model |
| | 072 | Photographic records - intraoral set |
| | 073 | Photographic records - extraoral set |
| | 074 | Diagnostic wax-up |
| | 081 | Cephalometric tracing & analysis - excluding radiographs |
| | 085 | Electromyographic recording |
| | 086 | Electromyographic analysis |
| | 104 | Specialist, referred consultation - Surgery, Hospital or Nursing Home |
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| | PREVENTIVE SERVICES |
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| | Dental prophylaxis and Bleaching |
| | 111 | Removal of plaque and/or stain |
| | 113 | Recontouring of pre-existing restoration(s) |
| | 114 | Removal of calculus - first visit |
| | 115 | Removal of calculus - subsequent visit |
| | 116 | Enamel micro-abrasion - per tooth |
| | 117 | Bleaching, internal - per tooth |
| | 118 | Bleaching, external - per tooth |
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| | Topical fluoride |
| | 121 | Top. appl. of remineralizing or cariostatic agent, one treatment |
| | 123 | Concentrated remineralizing or cariostatic agent, application - single tooth |
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| | Other preventive services |
| | 131 | Dietary advice |
| | 141 | Oral hygiene instruction |
| | 151 | Provision of mouthguard - indirect |
| | 161 | Fissure sealing - per tooth |
| | 165 | Desensitising procedure - per visit. |
| | 171 | Odontoplasty - per tooth |
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| | PERIODONTICS |
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| | 213 | Treatment of acute periodontal infection - per visit |
| | 221 | Clinical periodontal analysis and recording |
| | 222 | Root planing and subgingival curettage - per eight teeth or less |
| | 225 | Non surgical perio t'ment where not otherwise specified - per visit |
| | 231 | Gingivectomy - per eight teeth or less |
| | 232 | Periodontal flap surgery - per eight teeth or less |
| | 235 | Gingival graft - per tooth or implant |
| | 236 | Guided tissue regeneration - per tooth or implant |
| | 237 | Guided tissue regeneration - membrane removal |
| | 238 | Periodontal flap surgery for crown lengthening - per tooth |
| | 241 | Root resection - per root |
| | 242 | Osseous surgery - per eight teeth or less |
| | 243 | Osseous graft |
| | 245 | Periodontal surgery involving one tooth or an implant |
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| | ORAL SURGERY |
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| | Extractions |
| | 311 | Removal of a tooth or part(s) thereof. |
| | 314 | Sectional removal of a tooth |
| | 316 | Removal of additional tooth or part(s) thereof |
| | |
| | Surgical extractions |
| | 322 | Surg removal of tooth/fragment not requiring removal of bone or tooth division |
| | 323 | Surg removal of tooth/fragment requiring removal of bone |
| | 324 | Surg removal of tooth/fragment requiring both removal of bone and tooth division |
| | |
| | Surgery for prostheses |
| A | 331 | Alveolectomy - per segment |
| A | 332 | Ostectomy - per jaw |
| | 337 | Reduction of fibrous tuberosity |
| | 338 | Reduction of flabby ridge - per segment |
| A | 341 | Removal of hyperplastic tissue |
| | 343 | Repositioning of muscle attachment |
| | 344 | Vestibuloplasty |
| | 345 | Skin or mucosal graft |
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| | Treatment of maxillo-facial injuries |
| | 351 | Repair of skin and subcutaneous tissue or mucous membrane |
| | 352 | Fracture of maxilla or mandible - not requiring splinting |
| | 353 | Fracture of max or mand - with wiring of teeth or intra-oral fixation |
| | 354 | Fracture of maxilla or mandible - with external fixation |
| | 355 | Fracture of the zygoma |
| | 359 | Fracture of the maxilla or mandible requiring open reduction |
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| | Dislocations |
| | 361 | Mandible - relocation following dislocation |
| | 363 | Mandible - relocation requiring open operation |
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| | Osteotomies |
| | 365 | Osteotomy - maxilla |
| | 366 | Osteotomy - mandible |
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| | General surgical |
| | 371 | Removal of tumour, cyst or scar - cutan, subcutan. or in mucous mem. |
| | 373 | Removal of tumour, cyst or scar involv muscle, bone or other deep tissue |
| | 375 | Surgery to salivary duct |
| | 376 | Surgery to salivary gland |
| | 378 | Surgical removal of foreign body |
| | 379 | Marsupialisation of cyst |
| | |
| | Other surgical procedures |
| | 381 | Surgical exposure of unerupted tooth |
| | 382 | Surgical exposure and attachment of device for orthodontic traction |
| | 384 | Repositioning of displaced tooth/teeth - per tooth |
| | 385 | Surgical repositioning of unerupted tooth |
| | 386 | Splinting of displaced tooth/teeth |
| | 387 | Replantation and splinting of tooth |
| | 388 | Transplantation of tooth or tooth bud |
| | 389 | Surgery to isolate and preserve neurovascular tissue |
| | 391 | Frenectomy |
| | 392 | Drainage of abcess |
| | 393 | Surgery involving the maxillary antrum |
| | 394 | Surgery for osteomyelitis |
| | 395 | Repair of nerve trunk |
| | 399 | Control of reactionary or secondary post-operative haemorrhage |
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| | ENDODONTICS |
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| | Pulp treatments |
| | 411 | Direct pulp capping |
| | 412 | Incomplete endo therapy (inoperable or fractured tooth) |
| | 414 | Pulpotomy |
| | 415 | Complete chemo-mech prep of root canal - one canal |
| | 416 | Complete chemo-mech prep of root canal - each add'l canal |
| | 417 | Root canal obturation - one canal |
| | 418 | Root canal obturation - each additional canal |
| | 419 | Extirpation of pulp or debridement of root canal(s) - emergency |
| | 421 | Resorbable root canal filling - primary tooth |
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| | Periradicular surgery |
| | 431 | Periapical curettage - per root |
| A | 432 | Apicetomy - per root |
| A | 433 | Exploratory periradicular surgery |
| A | 434 | Apical seal - per canal |
| | 436 | Sealing of perforation |
| | 437 | Surgical treatment and repair of ext root resorption - per tooth |
| | 438 | Hemisection |
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| | Other endodontic services |
| | 445 | Exploration and/or negotiation of a calcified root canal - per canal, per visit |
| | 451 | Removal of a root filling - per canal |
| | 452 | Removal of cemented root canal post or post crown |
| | 453 | Removal or bypassing fractured endodontic instrument |
| | 455 | Add'l visit for irrigation and/or dressing of root canal system - per tooth |
| | 457 | Obturation of resorption defect or perforation (non surgical) |
| | 458 | Interim therapeutic root filling - per tooth |
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| | RESTORATIVE SERVICES |
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| | Metallic restorations |
| | 511 | Metallic restoration - one surface - direct |
| | 512 | Metallic restoration - two surfaces - direct |
| | 513 | Metallic restoration - three surfaces - direct |
| | 514 | Metallic restoration - four surfaces - direct |
| | 515 | Metallic restoration - five surfaces - direct |
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| | Tooth-coloured Adhesive resin restorations |
| | 521 | Adhesive resin restoration - one surface - anterior tooth - direct |
| | 522 | Adhesive resin restoration - two surface - anterior tooth - direct |
| | 523 | Adhesive resin restoration - three surfaces - anterior tooth - direct |
| | 524 | Adhesive resin restoration - four surfaces - anterior tooth - direct |
| | 525 | Adhesive resin restoration - five surfaces - anterior tooth - direct |
| | 531 | Composite resin restoration - one surface - posterior tooth - direct |
| | 532 | Composite resin restoration - two surface - posterior tooth - direct |
| | 533 | Composite resin restoration - three surfaces - posterior tooth - direct |
| | 534 | Composite resin restoration - four surfaces - posterior tooth - direct |
| | 535 | Composite resin restoration - five surfaces - posterior tooth - direct |
| | 531G | GIC restoration - one surface - posterior tooth - direct |
| | 532G | GIC restoration - two surface - posterior tooth - direct |
| | 533G | GIC restoration - three surfaces - posterior tooth - direct |
| | 534G | GIC restoration - four surfaces - posterior tooth - direct |
| | 535G | GIC restoration - five surfaces - posterior tooth - direct |
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| | Inlays/onlays - Indirect |
| | 541 | Metallic restoration - one surface - indirect |
| | 542 | Metallic restoration - two surfaces - indirect |
| | 543 | Metallic restoration - three surfaces - indirect |
| | 544 | Metallic restoration - four surfaces - indirect |
| | 545 | Metallic restoration - five surfaces - indirect |
| | 551 | Tooth-coloured restoration - one surface - indirect |
| | 552 | Tooth-coloured restoration - two surfaces - indirect |
| | 553 | Tooth-coloured restoration - three surfaces - indirect |
| | 554 | Tooth-coloured restoration - four surfaces - indirect |
| | 555 | Tooth-coloured restoration - five surfaces - indirect |
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| | Other restorative services |
| | 572 | Provisional (Intermediate/Temporary) restoration |
| | 574 | Metal Band |
| | 575 | Pin retention - per pin |
| | 576 | Metallic crown |
| | 577 | Cusp Capping - per cusp |
| | 579 | Bonding of Tooth Fragment |
| | 582 | Veneer - direct |
| | 583 | Veneer - indirect |
| | 596 | Recementing of inlay/onlay |
| | 597 | Post - direct |
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| | FIXED PROSTHODONTICS |
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| | Crowns |
| A | 611 | Full crown - acrylic resin - indirect |
| A | 613 | Full crown - non metallic - indirect |
| A | 615 | Full crown - veneered - indirect |
| A | 618 | Full crown - metallic - indirect |
| A | 625 | Post and core for crown - indirect |
| A | 627 | Preliminary restoration for crown - direct |
| | 629 | Post and root cap - indirect |
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| | Temporary Crown and Bridge |
| | 631 | Provisional crown |
| | 632 | Provisional bridge - per pontic |
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| | Bridges |
| | 642 | Bridge pontic - direct - per pontic |
| | 643 | Bridge pontic - indirect - per pontic |
| | 644 | Semi-fixed attachment |
| | 645 | Precision or magnetic attachment |
| | 649 | Retainer for bonded bridge - indirect - per tooth |
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| | Crown and Bridge Repairs and Other Services |
| | 651 | Recementing crown or veneer |
| | 652 | Recementing bridge or splint - per abutment |
| | 653 | Rebonding of bridge or splint where retreatm't of bridge surface is req'd |
| | 655 | Removal of crown |
| | 656 | Removal of bridge or splint |
| | 658 | Repair of crown, bridge or splint - indirect |
| | 659 | Repair of crown, bridge or splint - direct |
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| | Procedures for Implant prostheses |
| | 661 | Fitting of implant abutment - per abutment |
| | 662 | Provisional Implant Crown abutment - per abutment |
| | 663 | Removal of implant |
| | 664 | Fitting of bar for denture - per abutment |
| | 666 | Prosthesis with metal frame attached to implants - per tooth |
| | 668 | Fixture or abutment screw removal and replacement |
| | 669 | Removal and reattachment of prosthesis fixed to implant(s) - per implant |
| | 671 | Full crown attached to osseointegrated implant - non metallic - indirect |
| | 672 | Full crown attached to osseointegrated implant - veneered - indirect |
| | 673 | Full crown attached to osseointegrated implant - metallic - indirect |
| | 679 | Surgical implant guide |
| | 684 | Insertion of first stage of two-stage endosseous implant - per implant |
| | 688 | Insertion of one-stage endosseous implant - per implant |
| | 691 | Second stage surgery of two-stage endosseous implant - per implant |
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| | REMOVABLE PROSTHODONTICS |
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| | Dentures and Denture Components |
| | 711 | Complete maxillary denture |
| | 712 | Complete mandibular denture |
| | 716 | Metal palate or plate |
| | 719 | Complete maxillary and mandibular dentures |
| | 721A | Partial maxillary denture - resin base, one tooth, insert appliance |
| | 721B | Partial maxillary denture - resin base, two teeth, insert appliance |
| | 721C | Partial maxillary denture - resin base, three teeth, insert appliance |
| | 721D | Partial maxillary denture - resin base, four teeth, insert appliance |
| | 721E | Partial maxillary denture - resin base, five to nine teeth inclusive, insert appliance |
| | 721F | Partial maxillary denture - resin base, ten to twelve teeth inclusive, insert appliance |
| | 722A | Partial mandibular denture - resin base, one tooth, insert appliance |
| | 722B | Partial mandibular denture - resin base, two teeth, insert appliance |
| | 722C | Partial mandibular denture - resin base, three teeth, insert appliance |
| | 722D | Partial mandibular denture - resin base, four teeth, insert appliance |
| | 722E | Partial mandibular denture - resin base, five to nine teeth inclusive, insert appliance |
| | 722F | Partial mandibular denture - resin base, ten to twelve teeth inclusive, insert appliance |
| | 727A | Partial maxillary denture - cast metal framework, one tooth, insert appliance |
| | 727B | Partial maxillary denture - cast metal framework, two teeth, insert appliance |
| | 727C | Partial maxillary denture - cast metal framework, three teeth, insert appliance |
| | 727D | Partial maxillary denture - cast metal framework, four teeth, insert appliance |
| | 727E | Partial maxillary denture - cast metal framework, five to nine teeth inclusive, insert appliance |
| | 727F | Partial maxillary denture - cast metal framework, ten to twelve teeth inclusive, insert appliance |
| | 728A | Partial mandibular denture - cast metal framework, one tooth, insert appliance |
| | 728B | Partial mandibular denture - cast metal framework, two teeth, insert appliance |
| | 728C | Partial mandibular denture - cast metal framework, three teeth, insert appliance |
| | 728D | Partial mandibular denture - cast metal framework, four teeth, insert appliance |
| | 728E | Partial mandibular denture - cast metal framework, five to nine teeth inclusive, insert appliance |
| | 728F | Partial mandibular denture - cast metal framework, ten to twelve teeth inclusive, insert appliance |
| | 731 | Retainer - per tooth |
| | 732 | Occlusal rest |
| | 734 | Overlays - per tooth |
| | 735 | Precision or magnetic denture attachment |
| | 736 | Immediate tooth replacement - per tooth |
| | 737 | Resilient lining |
| | 738 | Wrought Bar |
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| | Denture maintenance |
| | 741 | Adjustment of pre-existing denture |
| | 743 | Relining - complete denture - processed |
| | 744 | Relining - partial denture - processed |
| | 745 | Remodelling - complete denture |
| | 746 | Remodelling - partial denture |
| | 751 | Relining - complete denture - direct |
| | 752 | Relining - partial denture - direct |
| | 753 | Cleaning & Polishing of pre-existing denture |
| | 754 | Denture base modification |
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| | Denture repairs |
| | 761 | Reattaching pre-existing tooth or clasp to denture |
| | 762 | Replacing/adding clasp on denture |
| | 763 | Repairing broken base of a complete denture |
| | 764 | Repairing broken base of a partial denture |
| | 765 | Replacing tooth on denture - per tooth |
| | 767 | Tooth replacement in addition to other repairs |
| | 768 | Adding tooth to part. denture to replace extracted or decoronated tooth - per tooth |
| | 769 | Repair or addition to metal casting |
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| | Other prosthodontic services |
| | 771A | Tissue conditioning preparatory to impressions - one treatment |
| | 771B | Tissue conditioning preparatory to impressions - two treatments |
| | 771C | Tissue conditioning preparatory to impressions - three treatments |
| | 772 | Splint - resin - indirect |
| | 774 | Obturator |
| | 776 | Impression - denture repair/modification |
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| | ORTHODONTICS |
| | | |
| | Removable appliances |
| A | 811 | Passive removable appliance - per arch. Retainer, bite plane |
| A | 821 | Active removable appliance - per arch or Forsus Appl |
| | 823 | Functional orthopaedic appliance incl CBJ & Herbst |
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| | Fixed appliances |
| | 829 | Partial banding - one arch |
| | 831 | Full arch banding - one arch |
| | 841 | Fixed Pal/Ling Arch Appl, Quadh, TP Arch |
| | 843 | Rapid Maxillary expansion appliance |
| | 845 | Passive Fixed Appl-Incl Bond/Banded Ret |
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| | Extra-oral appliance |
| | 851 | Extra-oral Appl-Headgear Incl All Comp |
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| | Attachments |
| | 862 | Bonding of attachment for application of orthodontic force |
| | |
| | Other orthodontic services |
| A | 871 | Orthodontic adjustment |
| A | 875 | Repair removable appliance - resin base |
| | 876 | Repair removable appliance - clasp, spring or tooth |
| A | 877 | Addition to removable appliance - clasp, spring or tooth |
| | |
| | Complete orthodontic treatment |
| | 881 | Complete course of orthodontic treatment |
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| | GENERAL SERVICES |
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| | Emergencies |
| | 911 | Palliative care |
| | 915 | After hours call out |
| | 916 | Travel to provide services |
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| | Drug therapy |
| | 926 | Individually made Tray - medicament(s) |
| | 927 | Provision of medication/medicament |
| | 928 | Intravenous cannulation and establishment of infusion |
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| | Professional visits |
| | 935 | Interpreter |
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| | Anaesthesia and sedation |
| | 942 | Sedation - intravenous - per 30 mins or part thereof |
| | 943 | Sedation - inhalation - per 30 mins or part thereof |
| | 944 | Relaxation therapy |
| | 946 | General anaesthesia - intravenous |
| | 947 | General anaesthesia - inhalation |
| | 948 | General anaesthesia - intubation |
| | 949 | Treatment under general anaesthesia/sedation |
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| | Occlusal therapy (craniomandibular disorders) |
| | 961 | Minor occlusal adjustment - per visit. |
| | 963 | Clinical occlusal analysis including muscle and joint palpation |
| | 964 | Registration and mounting of models for occlusal analysis |
| A | 965 | Occlusal splint |
| A | 966 | Adjustment of pre-existing occlusal splint - per visit |
| | 967 | Pantographic Tracing |
| | 968 | Occlusal adjustment following occlusal analysis - per visit |
| | 971 | Adjunctive physical therapy for TMJ and associated structures |
| A | 972 | Repair/addition - occlusal splint |
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| | MISCELLANOUS |
| | | |
| | 981 | Splinting and stabilisation - direct - per tooth |
| | 982 | Enamel stripping - per visit |
| | 984 | Bimaxillary Oral appliance for diagnosed snoring and obstructive sleep apnoea |
| | 986 | Post-operative care not otherwise included |