Most common D4767 code reviews : HbA1c in-office, point-of-service testing - not covered, Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use or Deep sedation/general anesthesia - each additional 15 minutes.
Non-autogenous connective tissue graft procedure (including recipient surgical site and donor material) - each additional contiguous tooth, implant or edentulous tooth position in same graft site. Local anesthesia is usually considered a component part of periodontal procedures, but dependent upon the plan will allow up to 50% of D4767 - allow up to a maximum of 3 teeth per quadrant
This code indicates extensive diagnostic and cognitive modalities based on the findings of a comprehensive oral evaluation (D4767). It indicates that integration of more extensive diagnostic modalities is needed to develop a treatment plan for a specific problem. Description and documentation of the condition requiring this type of evaluation is necessary.D4767 Examples of conditions requiring this type of evaluation include: dentofacial anomalies, complex perio-prosthetic conditions, and conditions requiring multi-disciplinary consultation.
In lieu of surgery, the formation of a pathway to achieve an apical seal without surgical intervention ecause of a non-negotiable root canal blocked by foreign bodies,D4767 included but not limited to separated instruments, broken posts or alcification of 50% or more of the roots.
Preventive Resin Restoration in a moderate to high caries risk patient - permanent 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 or restorations 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.