Discretionary fee guide Fees effective from 1 April 2017.

Transcription

1 Practitioner Services Discretionary fee guide Fees effective from 1 April 2017.

2 Contents Procedures to assist diagnosis and treatment planning 1 Non-surgical periodontal treatment 1-2 Permanent fillings 2-3 Endodontic treatment 3 Porcelain veneers 4 Inlays and crowns 4-7 Provision of bridges 7-9 Extractions of special difficulty and other oral surgery 9-11 Sedations Prostheses, obturators and other (non-orthodontic) appliances 12 Repairs and alterations to dentures Obturators, splints and similar appliances other than orthodontic appliances 15 Repairs to orthodontic appliances Miscellaneous treatments 16 Any other treatment: for treatment necessary to secure and maintain oral health, but not included elsewhere in this fee scale, predetermined fee items Radiographic examination and radiological report (occasional treatment) 18 Inlays, crowns and bridges (occasional treatment) Repairs and alterations to dentures and other appliances Any other incomplete treatment 21

3 The new Discretionary Fee Guide The Scottish Dental Practice Board (SDPB) commissioned Practitioner Services (PSD) to carry out a review of the discretionary item fees. The current system has been in operation for many years without formal review or significant change, and there are a number of concerns as to its transparency, consistency, ability to circumvent controls and lack of ability to take advantage of new electronic ways of working. The main concerns were around clarity of process from the dental practitioner s perspective, consistency of awarding a fee where it could not be pre-determined, and reliance on paper. The review of the discretionary items and fees was carried out under the discretionary review project. As part of the review it was agreed that changes were required, these changes were applied to all discretionary items. The new dental discretionary items were to be made available to practitioners and published. Note: One of the changes required was the deletion of 40 in the Statement of Dental Remuneration. 40 has been replaced by two new discretionary items: s 38 and 39 (s require ) z 38 Any other treatment: for treatment necessary to secure and maintain oral health, but not included elsewhere in this fee scale, pre-determined fee items; z 39 Any other treatment: for treatment necessary to secure and maintain oral health, but not included elsewhere in this fee scale, non pre-determined fee items. 38 contains the discretionary item codes that have a fee attached and 39 contains those discretionary items that require a fee to be given by PSD. 38, once approved can be processed as you would any other code. The full list of discretionary items, fee codes and fees are detailed within this Dental Discretionary Fee Guide.

4 Process to claim and submit discretionary zero value items Prior approval / discretionary fee request All prior approval claims are to be submitted on the claim form GP17-1 to: Requests Dental Practice Division PO BOX Edinburgh, EH12 9WY Requesting item 39 (fee for a discretionary item) The request process is detailed below: z Paper GP17 submission with claim for item 39; z The claim will be assessed by a dental adviser; z Claim will either be approved, returned for more information or declined. If approved, the approval date and appropriate fee for the item 39 code will be provided. Claim will be returned to the dentist to begin treatment.

5 Approval and claim process - requesting discretionary fee for item 39 prior approval and request for fee (discretionary) submissions for payment (options for submission) Dentist Dental Advisor prior approval team Submits paper GP17-1 form for prior approval / discretionary fee request Request reviewed by dental Advisor Returned requesting additional information or request not approved No Request approved? Dentist completes treatment and enters the appropriate information on the claim form GP17 returned to dentist with approval date and discretionary fee amount awarded Approval details recorded Paper GP17-1 form submission Include: 6 digit item 39 code and approval date. In observations state Discretionary fee awarded for item 39 and fee amount awarded. Electronic Data Interchange (EDI): Claim to be submitted electronically Include: 6 digit item 39 code and approval date. In observations state Discretionary fee awarded for item 39 and fee amount awarded. edental Electronic claim submission from Practice Management System (PMS) Include: 6 digit item 39 code and fee amount awarded. Add approval date. edental web form submission Include: Approval date. Enter amount awarded in the specified fee value field against the 6 digit item 39 code. PSD Form scanned and processed to MIDAS dental payment system MIDAS dental payment system MIDAS dental payment system Customer admin Recorded approval details Observations presented to operator to enter / validate codes and total Return to dentist: paper - by rejection letter edental - by rejection letter EDI - electronically No Verified for payment? Process for payment Presented to operator at manual intervention for verification

6 Paper GP17 form resubmitted for payment The form must include the item 39 treatment code; approval date and in the observations the following must be detailed: z Must state Discretionary fee awarded for item 39 ; and z The amount awarded. The claim, once submitted, will be processed for payment. Electronic Data Interchange (EDI): claim to be submitted electronically The Claim must include the item 39 treatment code; approval date and in the observations the following must be detailed: z Must state Discretionary fee awarded for item 39 ; and z The amount awarded. The claim, once submitted, will be processed for payment. edental: Electronic claim submitted from PMS (Transitioned Practice) The claim must include the item 39 treatment code; the approval date and the amount awarded detailed against the item 39 treatment code. The total fee being claimed should be amended in your system to include the fee awarded for the discretionary item. The claim, once submitted, will be processed for payment. edental: Web form to be completed The claim must include the item 39 treatment code; the approval date and the amount awarded detailed in the specified fee value field on the Value Summary tab against the item 39 treatment code. The total fee being claimed will be amended to include the fee awarded for the discretionary item, when you select the refresh button. The claim, once submitted, will be processed for payment.

7 Number Description Fee Code Qualifier Dentist Procedures to Assist Diagnosis and Treatment Planning 2[A][4] Discretionary OPT Analysis Should only be claimed where OPT has been taken at a different location. Same dentist rule applies No No 2 Discretionary [1] Occlusal Analysis No No 2 Discretionary [2] Adjustable Articulator Mounting of study casts on an adjustable articulator where necessary in complex cases No No 36[C] Occlusal Equilibration No 38 Discretionary [54] Anatomical articulation with Face Bow transfer 38 Discretionary [23] Provision of a Lucia jig See also under item No No 38 Discretionary [31] Diagnostic wax-ups per tooth All teeth 38 Discretionary [58] Provision of upper & lower study casts & articulation in cases of TMJ dysfunction No 38 Discretionary [59] Provision of a duplicate single study cast No Non-Surgical Periodontal Treatment 10[E] Discretionary [1] 10[E] Discretionary [2] 10[E] Discretionary [3] Splinting of periodontally compromised teeth: (one union) Dental Advisers would appreciate appropriate radiographs if available. Splinting of periodontally compromised teeth: (two unions) Dental Advisers would appreciate appropriate radiographs if available. Splinting of periodontally compromised teeth: (three unions) Dental Advisers would appreciate appropriate radiographs if available No No No page 1

8 Number Description Fee Code Qualifier Dentist Non-Surgical Periodontal Treatment 10[E] Discretionary [4] 11[E] Discretionary [4] Permanent Fillings 14[F] Discretionary [7] 14[F] Discretionary [8] 14[F] Discretionary [9] Splinting of periodontally compromised teeth: (four or more unions) Dental Advisers would appreciate appropriate radiographs if available. Single Tooth Gingivectomy Other than treatment claimed under item 11(d). Removal of Amalgam & Replacing Resin Single Surface Must be supported by appropriate consultants report. Removal of Amalgam & Replacing Resin MO or DO Must be supported by appropriate consultants report. Removal of Amalgam & Replacing with Resin MOD Must be supported by appropriate consultants report. 38 Discretionary [1] Stabilising of tooth with a non-amalgam filling (pregnant+nursing mother) Material not specified. 38 Discretionary [2] Addition of composite resin to teeth where an appropriate SDR fee is not available - no tooth preparation necessary Normally used to treat non carious tooth surface loss. 38 Discretionary [3] Addition of composite resin to teeth where an appropriate SDR fee is not available - tooth preparation necessary Normally used to treat non carious tooth surface loss No All teeth All teeth page 2

9 Number Description Fee Code Qualifier Dentist Permanent Fillings 38 Discretionary [4] Addition of composite resin to teeth where an appropriate SDR fee is not available - composite build up Normally used to treat non carious tooth surface loss. 38 Discretionary [23] Provision of a Lucia jig Laboratory manufactured stent to be used in conjunction with composite build ups. 38 Discretionary [49] Full coverage in cases of gross tissue loss/ malformed incisors/peg shaped laterals 38 Discretionary [5] Addition of composite resin to teeth where an appropriate SDR fee is not available - extensive restoration Normally used to treat extensive non carious tooth surface loss. 38 Discretionary [50] Refacing of labial surfaces of a tooth in cases of hypoplasia etc. Endodontic Treatment 15[C][4] 15[C][7] Apicectomy on an upper molar tooth, 1 palatal root only No fee shall be payable unless appropriate radiographs are available. Apicectomy on a lower molar tooth, 1 root No fee shall be payable unless appropriate radiographs are available No All teeth Discretionary [1] Apexification *(TBD) *(TBD) No No page 3

10 Number Description Fee Code Qualifier Dentist Porcelain Veneers 38 Discretionary [6] Indirect composite veneer Discretionary [7] Porcelain veneers on teeth other than - upper 321/123 (first veneer in arch) 38 Discretionary [8] Each subsequent veneer in arch (porcelain veneers on teeth other than - upper 321/123) Discretionary [44] Gold shims All teeth 38 Discretionary [45] Shims - precious metal alloy All teeth 38 Discretionary [46] Shims - NON precious metal alloy All teeth Inlays and Crowns 17[I] First [1] First or only crown in the same jaw No 17[I] Discretionary [49] 17[I] Discretionary [50] Three quarter crown (non-precious metal) Crown (full or jacket crown stainless steel prefabricated) [J][2][1] First or only crown in the same jaw No No 17[J][2] Discretionary [14] 17[J][2] Discretionary [15] 17[J][2] Discretionary [16] One unit (repair to porcelain in situ using special repair kit) Two units (repair to porcelain in situ using special repair kit) Max fee (repair to porcelain in situ using special repair kit) No No No No No No page 4

11 Number Description Fee Code Qualifier Dentist Inlays and Crowns 17[J][2] Discretionary [26] 17[J][2] Discretionary [27] 17[J][2] Discretionary [28] 17[J][2] Discretionary [29] 17[J][2] Disc [30] Removal of a crown (prior to repair) Prior to repair, not replacement. Insertion of a pin/screw (F4) + recementing crown Insertion of core & post prefabricated in nonprecious metal (F3) + recementing crown Insertion of a Kurer crown saver or cast metal post (F2) + recementing crown Dentine bonded core on root treated molar teeth 38 Discretionary [9] Precious bonded crown - metal/ceramic crown on a molar tooth (includes first crown in arch fee) Colour clinical photograph required to demonstrate a non retracted natural smile. 38 Discretionary [10] Non precious bonded crown - metal/ceramic crown on a molar tooth (includes first crown in arch fee) Colour clinical photograph required to demonstrate a non retracted natural smile. 38 Discretionary [11] Laboratory constructed temporary crown Normally appropriate in staged treatment plans. 38 Discretionary [12] Single surface cavity (inlays/pinlays - precious metal) 38 Discretionary [13] Compound cavity (inlays/pinlays - precious metal) 38 Discretionary [14] Confluent compound cavity (inlays/pinlays - precious metal) All teeth All teeth All teeth All teeth All teeth All teeth All teeth All teeth No No No No No page 5

12 Number Description Fee Code Qualifier Dentist Inlays and Crowns 38 Discretionary [15] Single surface cavity (inlays/pinlays - non precious metal) 38 Discretionary [16] Compound cavity (inlays/pinlays - non precious metal) 38 Discretionary [17] Confluent compound cavity (inlays/pinlays - non precious metal) All teeth All teeth All teeth 38 Discretionary [18] Porcelain inlays MO/DO Discretionary [19] Porcelain inlays MOD Discretionary [20] Indirect composite inlay MO/DO Discretionary [21] Indirect composite inlay MOD Discretionary [22] First or only inlay per arch No 38 Discretionary [28] Post-retained diaphragm (non-precious metal) All teeth 38 Discretionary [29] Gold coping (60% or more fine gold) All teeth 38 Discretionary [30] Gold coping (precious metal) All teeth 38 Discretionary [26] Post-retained diaphragm (60% or more fine gold) All teeth 38 Discretionary [27] Post-retained diaphragm (precious metal) All teeth 38 Discretionary [38] Indirect composite/porcelain onlay All teeth page 6

13 Number Description Fee Code Qualifier Dentist Inlays and Crowns 38 Discretionary [39] 60% or more fine gold onlay All teeth 38 Discretionary [40] Precious metal alloy onlay All teeth 38 Discretionary [41] Non precious metal alloy onlay All teeth 38 Discretionary [42] Ceramic onlay All teeth 39 Discretionary [2] Onlays: Indirect composite/porcelain *(TBD) *(TBD) All teeth 39 Discretionary [3] Onlays: 60% or more fine gold *(TBD) *(TBD) All teeth 39 Discretionary [4] Onlays: precious metal alloy *(TBD) *(TBD) All teeth 39 Discretionary [5] Metal acid etch inlay *(TBD) *(TBD) All teeth 39 Discretionary [6] Removal of a post in exceptional circumstances Prior to repair or replacement of existing restoration involving e.g. masserann kit. 39 Discretionary [7] Crown/bridge restorations and other laboratory-based items (where there is no predetermined fee available under items 17(I) or 18(E)) 39 Discretionary [8] Repair of a crown/bridge involving soldering (where there is no predetermined fee available under items 17(J) or 18(H)) Provision of Bridges 18[B][5] Disc [1] 18[B][5] Disc [2] 18[E] Discretionary [29] 18[E] Discretionary [30] 18[E] Discretionary [31] Bridge laboratory constructed dovetail (one tooth) Bridge laboratory constructed dovetail (two teeth) *(TBD) *(TBD) All teeth *(TBD) *(TBD) All teeth *(TBD) *(TBD) No No No No No Spring cantilever arm - 60% or more fine gold No Spring cantilever arm - precious metal No Spring cantilever arm - non-precious metal No page 7

14 Number Description Fee Code Qualifier Dentist Provision of Bridges 18[E] Discretionary [33] [1] [7] Burnout attachment - Tubelock attachment No Removal or sectioning of a bridge prior to repair Claimed where part or all of the original bridge is retained. One unit (repair of precious metal bridge by rebonding porcelain of retainer &/or pontics) No No No No [8] [9] [14] [15] [16] [23] [24] [25] [26] [27] [28] Two units (repair of precious metal bridge by rebonding porcelain of retainer &/or pontics) Three units (repair of precious metal bridge by rebonding porcelain of retainer &/or pontics) One unit (repair to porcelain in situ using special repair kit) Two units (repair to porcelain in situ using special repair kit) Three units (repair to porcelain in situ using special repair kit) Veneer of bridge repair (includes additional fee) Dentine bonded core for bridges on root filled molars Insertion of 2 pin / screw / preformed post + recementing original bridge Insertion of 2 cast precious metal core + post and recementing original bridge Insertion of 2 cast non-precious metal core+post including Radix anchor and Kurer crown saver + recementing original bridge Insertion of 2 core+post prefabricated in nonprecious metal + recementing original bridge No No No No No No No No No No No No No No No No No No No No No No page 8

15 Number Description Fee Code Qualifier Dentist Provision of Bridges [29] [30] [31] [32] Insertion of pin / screw / preformed post + recementing original bridge Insertion of cast precious metal core + post & recementing original bridge Insertion of non-precious metal core + post including Radix anchor & Kurer crown saver + recementing original bridge All teeth All teeth All teeth Insertion of core+post prefabricated in nonprecious metal + recementing original bridge All teeth 39 Discretionary [7] Crown/bridge restorations and other laboratory-based items (where there is no predetermined fee available under items 17(I) or 18(E)) 39 Discretionary [8] Repair of a crown/bridge involving soldering (where there is no predetermined fee available under items 17(J) or 18(H)) Extractions of Special Difficulty and Other Oral surgery [8] [11] [12] *(TBD) *(TBD) All teeth *(TBD) *(TBD) No Removal of Operculum No Removal of Papilloma or Fibroma No Removal of Mucocoele No No No No No [13] Surgical exposure of unerupted canine or second premolar teeth - buccal flap, soft tissue only Appropriate radiographs must be available ,15,23, 25,33,35, 43,45, [14] Surgical exposure of unerupted canine or second premolar teeth - palatal flap, soft tissue only Appropriate radiographs must be available ,15,23, 25,33,35, 43,45 page 9

16 Number Description Fee Code Qualifier Dentist Extractions of Special Difficulty and Other Oral surgery [15] [16] [17] [18] [19] Closure of oro-antral communication by means of a buccal advancement flap Closure of oro-antral communication by means of a palatal flap Repair of lateral perforation in connection with items 1521/1541 Appropriate radiographs must be available. Surgical exposure of unerupted canine or second premolar teeth - buccal flap, bone removal Appropriate radiographs must be available. Surgical exposure of unerupted canine or second premolar teeth - palatal flap, bone removal Appropriate radiographs must be available. 38 Discretionary [55] Supply and bond non precious metal pad and chain 38 Discretionary [56] Supply and bond precious metal pad and chain No No No ,15,23, 25,33,35, 43,45 13,15,23, 25,33,35, 43, No No 38 Discretionary [57] Bond pad and chain supplied by orthodontist No [20] [21] [22] Surgical removal of impacted canine or upper second premolar teeth - buccal flap, bone removal Appropriate radiographs must be available. Surgical removal of impacted canine or upper second premolar teeth - palatal flap, bone removal Appropriate radiographs must be available. Surgical removal of impacted lower second premolar teeth Appropriate radiographs must be available ,15,23, 25,33,43 13,15,23, 25,33, ,45, page 10

17 Number Description Fee Code Qualifier Dentist Extractions of Special Difficulty and Other Oral surgery [23] [24] Surgical removal of unerupted mesiodens, odontome or supernumerary involving raising of a surgical flap and bone removal Appropriate radiographs must be available. Coronectomy of lower third molar teeth involving raising of a flap, bone removal and crown sectioning Appropriate radiographs must be available No ,48 39 Discretionary [9] Hemisection of a tooth *(TBD) *(TBD) Discretionary [96] Any other oral surgery procedures or complex procedures Sedations 25[A][3] Discretionary [1] 25[A][3] Discretionary [2] Sedation for patients in capitation treatment other than item 21 extraction. Where cost of treatment carried out under sedation at that visit is up to and including Where sedation is administered by a doctor or dentist other than the dentist carrying out the treatment. Sedation for patients in capitation treatment other than item 21 extraction. Where cost of treatment carried out under sedation at that visit is from to Where sedation is administered by a doctor or dentist other than the dentist carrying out the treatment *(TBD) *(TBD) No No No No No page 11

18 Number Description Fee Code Qualifier Dentist Sedations 25[A][3] Discretionary [3] 25[A][3] Discretionary [4] 25[A][4] Discretionary [1] Sedation for patients in capitation treatment other than item 21 extraction. Where cost of treatment carried out under sedation at that visit is from to Where sedation is administered by a doctor or dentist other than the dentist carrying out the treatment. Sedation for patients in capitation treatment other than item 21 extraction. Where cost of treatment carried out under sedation at that visit is greater than Where sedation is administered by a doctor or dentist other than the dentist carrying out the treatment. Sedation in connection with treatment involving the preparation & fitting of veneers, inlays, crowns or bridge retainers Where sedation is administered by a doctor or dentist other than the dentist carrying out the treatment No No No No No No 38 Discretionary [51] Hypnosis first or only visit No 38 Discretionary [52] Hypnosis second visit No 38 Discretionary [53] Hypnosis third or subsequent visit(s) No Prostheses, Obturators and other (Non-Orthodontic) Appliances 38 Discretionary [24] Relining/rebasing or provision/renewal of soft lining with material polymerised in the mouth, including tissue cond No 38 Discretionary [25] Provision of a custom incisal guide table No 39 Discretionary [11] Use of high impact acrylic in a denture *(TBD) *(TBD) No page 12

19 Number Description Fee Code Qualifier Dentist Repairs and Alterations to Dentures 28[A][3] Discretionary [1] 28[A][3] Discretionary [2] 28[A][3] Discretionary [3] 28[A][3] Discretionary [7] 28[B][2] Discretionary [1] 28[B][2] Discretionary [8] 28[B][2] Discretionary [9] 28[B][2] Discretionary [10] 28[B][2] Discretionary [11] 28[D][4] Discretionary [7] 28[D][4] Discretionary [8] Refixing or replacement of First Facing No No Refixing or replacement of each additional facing Refixing or replacement of facing (max. per denture) Soldering or welding repairs (stainless steel or chrome cobalt) No No No No No No Simple adjustments to acrylic element No No Denture bearing 1-3 teeth (stripping & reassembling the polymer & teeth) Denture bearing 4-8 teeth (stripping & reassembling the polymer & teeth) Denture bearing 9 or more teeth (stripping & reassembling the polymer & teeth) Full denture (stripping & reassembling the polymer & teeth) Reconstruction of a metal denture (stripping fee) Soldering or welding (stainless steel or chrome cobalt) 28 Discretionary [1] Additional clasp (must be claimed with ) 28 Discretionary [2] 1 Repair (fracture) balance fee (must be claimed with ) 28 Discretionary [4] Repair (fracture) balance fee (must be claimed with ) 28 Discretionary [5] Additional gum (must be claimed with ) No No No No No No No No No No No No No No No No No No No No page 13

20 Number Description Fee Code Qualifier Dentist Repairs and Alterations to Dentures 28 Discretionary [6] 1 Repair (fracture) balance fee (must be claimed with ) 28 Discretionary [7] Additional clasp (must be claimed with ) 28 Discretionary [8] 2 or more repairs balance fee (must be claimed with ) 28 Discretionary [10] 2 or more repairs balance fee (must be claimed with ) 28 Discretionary [11] Additional gum (must be claimed with ) 28 Discretionary [12] 2 or more repairs balance fee (must be claimed with ) 28 Discretionary [13] Additional clasp (must be claimed with ) 28 Discretionary [14] Refix clasp balance fee (must be claimed with ) 28 Discretionary [16] Refix clasp balance fee (must be claimed with ) 28 Discretionary [17] Additional gum (must be claimed with ) 28 Discretionary [18] Refix clasp balance fee (must be claimed with ) No No No No No No No No No No No No No No No No No No No No No No 28 Discretionary [19] Any 2 additions with or without repairs (max) No No 28 Discretionary [20] Additional tooth (must be claimed with ) 28 Discretionary [21] Additional tooth (must be claimed with ) 28 Discretionary [22] Additional tooth (must be claimed with ) All teeth No All teeth No All teeth No page 14

21 Number Description Fee Code Qualifier Dentist Obturators, Splints and Similar Appliances other than Orthodontic Appliances 29[A] Discretionary 29[C][6] Disc [1] 29[C][6] Disc [2] 29[C][6] Disc [3] 29[C][6] Disc [4] 29[F] Discretionary 29[E] Discretionary [1] 29[E] Discretionary [19] 29[E] Discretionary [20] Repairs to Orthodontic Appliances 32[C][4] Lower Disc [1] 32[C][4] Upper Disc [2] 32[F] Discretionary [2] 32[F] Discretionary [3] 32[F] Discretionary [17] Obturators - fee per case, in addition to appropriate denture fee Provision of Maryland splint 2 units Splinting in connection with external trauma. Provision of Maryland splint 3 units Splinting in connection with external trauma. Provision of Maryland splint 4 units Splinting in connection with external trauma. Provision of Maryland splint 5 or more units Splinting in connection with external trauma. Provision of a laboratory processed pressure-formed soft occlusal appliance Denture base polymer appliance carrying no teeth Prosthetic, as an alternative to suturing, to cover oral-antral fistula No No No No No No No No No No No No No Full upper or lower training base No Lower repair of a fixed appliance involving the replacement of 2 or more bracket bands/ archwires Upper repair of a fixed appliance involving the replacement of 2 or more bracket bands/ archwires Replacement of one half of twin block functional appliance *(TBD) *(TBD) No No *(TBD) *(TBD) No No No Reset a twin block functional appliance No Cemented inclined plane (passive traction or deterrent) No page 15

22 Number Description Fee Code Qualifier Dentist Repairs to Orthodontic Appliances 32[F] Discretionary [18] 32[F] Discretionary [21] 32[F] Discretionary [51] 32[F] Discretionary [52] 32[F] Discretionary [53] 32[F] Discretionary [27] 32[F] Discretionary [50] Miscellaneous Treatments Space maintainer (passive traction or deterrent) No Bond (recementing bonded retainer) No Enamel stripping/discing per visit (one visit) No Enamel stripping/discing per visit (two visits) No Enamel stripping/discing per visit (three or more visits) Cephalometric not taken by the dentist providing analysis No No Hyrax Screw (rapid maxillary expansion) No 36[C] Occlusal Equilibration No 39 Discretionary [12] Incomplete treatment where there is no SDR fee 39 Discretionary [97] Chairside factor: additional time necessarily spent with a patient 39 Discretionary [98] Fee for necessary treatment involving laboratory expenses not covered by the SDR (TBC) (TBC) No (TBC) (TBC) No (TBC) (TBC) No 39 Discretionary [99] Fee for: Any other treatment (TBC) (TBC) No 39 Discretionary [10] Precision attachments (TBC) (TBC) All teeth page 16

23 Number Description Fee Code Qualifier Dentist Any other Treatment: For treatment necessary to secure and maintain oral health, but not included elsewhere in this fee scale, predetermined fee items. 38 Discretionary [32] Re-implantation of a tooth removed by trauma and treatment to root canal 38 Discretionary [33] Attention to socket - replacing tooth & temporary wiring or splinting - per unit 38 Discretionary [34] Attention to socket - replacing tooth & temporary wiring or splinting - per unit + fee for temporary splint 38 Discretionary [35] Use of a natural crown as a bridge pontic sectioning crown from root Normally claimed in conjunction with codes 3836 and Discretionary [36] Use of a natural crown as a bridge pontic attention to pulp chamber Normally claimed in conjunction with codes 3835 and Discretionary [37] Use of a natural crown as a bridge pontic acid etch splinting of teeth - per splint Normally claimed in conjunction with codes 3835 and No page 17

24 Number Description Fee Code Qualifier Dentist Any other Treatment: For treatment necessary to secure and maintain oral health, but not included elsewhere in this fee scale, predetermined fee items. 38 Discretionary [43] Abrasion of enamel opacities in vital teeth per arch No 38 Discretionary [47] Carbon fibre posts All teeth 38 Discretionary [48] Internal bleaching of a non-vital tooth Radiograph required and colour photograph if available. 38 Discretionary [55] Supply and bond non precious metal pad and chain 38 Discretionary [56] Supply and bond precious metal pad and chain No No 38 Discretionary [57] Bond pad and chain supplied by orthodontist No Radiographic Examination and radiological report (Occasional Treatment) 49[D] Discretionary OPT analysis Should only be claimed where OPT has been taken at a different location. Same dentist rule applies. Inlays, Crowns and Bridges (Occasional Treatment) 51[E] Discretionary [29] 51[E] Discretionary [30] 51[E] Discretionary [31] 51[E] Discretionary [32] 51[E] Discretionary [33] Insertion of pin/screw/preformed post + recementing original bridge Insertion of cast precious metal core + post & recementing original bridge Insertion of non-precious metal core + post including Radix anchor & Kurer Crown Saver + recementing original bridge Insertion of core + post prefabricated in nonprecious metal + recementing original bridge Removal of a bridge Normally claimed where part or all of the original bridge is retained No No All teeth No All teeth No All teeth No All teeth No No No page 18

25 Number Description Fee Code Qualifier Dentist Inlays, Crowns and Bridges (Occasional Treatment) 51[E] Discretionary [34] 51[E] Discretionary [35] 51[E] Discretionary [36] One unit (Repair to porcelain in situ using special repair kit) Two units (Repair to porcelain in situ using special repair kit) Three units (Repair to porcelain in situ using special repair kit) No No No No No No 55[A][3][1] Refixing or replacement to metal dentures No No 55[B][2] Discretionary 55[D][4] Discretionary [7] Discretionary [1] Discretionary [2] Discretionary [4] Adjusting a denture (other) No No Stainless steel or chrome cobalt (Soldering or welding additions) No No 1 Additional clasp No No 1 Repair balance fee No No 1 Repair balance fee No No Repairs and Alterations to Dentures and other Appliances Discretionary [5] Discretionary [6] Discretionary [7] Discretionary [8] Discretionary [10] Discretionary [11] 1 Additional gum No No 1 Repair balance fee No No 1 Additional clasp No No 2 or more repairs balance fee No No 2 or more repairs balance fee No No 1 additional gum No No page 19

26 Number Description Fee Code Qualifier Dentist Repairs and Alterations to Dentures and other Appliances Discretionary [12] Discretionary [13] Discretionary [14] Discretionary [16] Discretionary [17] Discretionary [18] Discretionary [19] 2 or more repairs balance fee No No 1 Additional clasp No No Refix clasp balance fee No No Refix clasp balance fee No No 1 Additional gum No No Refix clasp balance fee No No Any 2 additions with or without repairs No No Disc [20] 1 Additional tooth All teeth No Disc [21] 1 Additional tooth All teeth No Disc [22] 1 Additional tooth All teeth No 55[F] Discretionary [1] 55[F] Discretionary [2] 55[F] Discretionary [3] Recement one band (other repairs or adjustments to a fixed or removable appliance) Each additional band (other repairs or adjustments to a fixed or removable appliance) Removal of a bonded retainer (other repairs or adjustments to a fixed or removable appliance) No No No No No No 55[F] Discretionary [4] 55[F] Discretionary [5] Removal of ligatures (other repairs or adjustments to a fixed or removable appliance) No No Removal of a band or spring No No page 20

27 Number Description Fee Code Qualifier Dentist Repairs and Alterations to Dentures and other Appliances 55[F] Discretionary [6] 55[F] Discretionary [7] 55[F] Discretionary [8] 55[F] Discretionary [9] 55[F] Discretionary [10] 55[F] Discretionary [11] 55[F] Discretionary [12] 55[F] Discretionary [13] 55[F] Discretionary [14] Any other Incomplete Treatment Removal of a whole fixed appliance No No Removal of both arches (maximum fee) No No Adjustment of fixed/removable appliance No No Relining/rebasing an appliance No No 1 Bond (recementing bonded retainers) No No 2 or more bonds (recementing bonded retainers) No No 1 Visit (enamel stripping /discing) No No 2 visits (enamel striping /discing) No No Maximum (enamel stripping /discing) No No 73 Discretionary [1] Partial scaling 18 years or over at beginning of course of treatment No No page 21

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