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EMPLOYEE GROUP INS. RENEWALS -2012
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EMPLOYEE GROUP INS. RENEWALS -2012
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Last modified
2/16/2017 12:29:05 PM
Creation date
7/12/2013 10:31:02 AM
Metadata
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Template:
Contracts
Company Name
EMPLOYEE GROUP INS. RENEWALS
Contract #
A-2012-170
Agency
PERSONNEL SERVICES
Council Approval Date
8/6/2012
Expiration Date
12/13/2013
Destruction Year
2018
Notes
Amends A-2002-208 Amended by A-2014-176, A-2015-206, A-2015-207
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<br />Oral pathology laboratory <br />D0472 Accession of tissue, gross examination, preparation and transmission of written report <br />D0473 Accession of tissue, gross and microscopic examination, preparation and transmission of <br />written report <br />D0474 Accession of tissue, gross and microscopic examination, including assessment of surgical <br />margins for presence of disease, preparation and transmission of written report <br />D0475 Decalcification procedure <br />D0476 Special stains for microorganisms <br />D0477 Special stains, not for microorganisms <br />D0478 Immunohistochemical stains <br />D0479 Tissue in-situ hybridization, including interpretation <br />D0480 Accession of exfoliative cytologic smears, microscopic examination, preparation and <br />transmission of written report <br />D0481 Electron microscopy - diagnostic <br />D0482 Direct immunofluorescence <br />D0483 Indirect immunofluorescence <br />D0484 Consultation on slides prepared elsewhere <br />D0485 Consultation, including preparation of slides from biopsy material supplied by referring <br />source <br />D0486 Accession of brush biopsy sample, microscopic examination, preparation and transmission <br />of written report <br />D0502 Other oral pathology procedures, by report <br />D0999 Unspecified diagnostic procedure, by report <br />D1000 - D1999 PREVENTIVE <br />Dental prophylaxis <br />D1110 Prophylaxis - adult <br />D1120 Prophylaxis - child through age 13 <br />Topical fluoride treatment (office procedure) <br />D1203 Topical application of fluoride (prophylaxis not included) - child through age 13 <br />D1204 Topical application of fluoride (prophylaxis not included) - adult <br />D1206 Topical fluoride varnish; therapeutic application for moderate to high caries risk patients <br />Other preventive services <br />D1310 Nutritional counseling for control of dental disease <br />D1320 Tobacco counseling for the control and prevention of oral disease <br />D1330 Oral hygiene instructions <br />D1351 Sealant - per tooth <br />D1352 Preventive resin restoration in a moderate to high caries risk patient - permanent tooth <br />Space maintenance (passive appliances) <br />D1510 Space maintainer - fixed - unilateral <br />D1515 Space maintainer - fixed - bilateral <br />D1520 Space maintainer - removable - unilateral <br />D1525 Space maintainer - removable - bilateral <br />D1550 Recementation of space maintainer <br />D1555 Removal of fixed space maintainer <br />D2000 - D2999 RESTORATIVE <br />Amalgam restorations (including polishing) <br />D2140 Amalgam - one surface, primary or permanent <br />D2150 Amalgam - two surfaces, primary or permanent <br />D2160 Amalgam - three surfaces, primary or permanent <br />D2161 Amalgam - four or more surfaces, primary or permanent
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