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25C - AGMT GROUP INSURANCE
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25C - AGMT GROUP INSURANCE
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Last modified
2/1/2018 7:02:12 PM
Creation date
2/1/2018 7:10:52 PM
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City Clerk
Doc Type
Agenda Packet
Agency
Personnel Services
Item #
25C
Date
2/6/2018
Destruction Year
2023
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Other removable prosthetic services <br />D5850 Tissue conditioning - maxillary <br />D5851 Tissue conditioning - mandibular <br />D5862 Precision attachment, by report <br />D5863 Overdenture - complete maxillary <br />D5864 Overdenture - partial maxillary <br />D5865 Overdenture - complete mandibular <br />D5866 Overdenture - partial mandibular <br />D5867 Replacement of replaceable part of semi -precision or precision attachment (male or <br />female component) <br />D5875 Modification of removable prosthesis following Implant surgery <br />D5899 Unspecified removable prosthodontic procedure, by report <br />D5900 - D5999 MAXILLOFACIAL PROSTHETICS <br />D5911 <br />Facial moulage (sectional) <br />D5912 <br />Facial moulage (complete) <br />D5913 <br />Nasal prosthesis <br />D5914 <br />Auricular prosthesis <br />D5915 <br />Orbital prosthesis <br />D5916 <br />Ocular prosthesis <br />D5919 <br />Facial prosthesis <br />D5922 <br />Nasal septal prosthesis <br />D5923 <br />Ocular prosthesis, Interim <br />D5924 <br />Cranial prosthesis <br />D5925 <br />Facial augmentation Implant prosthesis <br />D5926 <br />Nasal prosthesis, replacement <br />D5927 <br />Auricular prosthesis, replacement <br />D5928 <br />Orbital prosthesis, replacement <br />D5929 <br />Facial prosthesis, replacement <br />D5931 <br />Obturator prosthesis, surgical <br />D5932 <br />Obturator prosthesis, definitive <br />D5933 <br />Obturator prosthesis, modification <br />D5934 <br />Mandibular resection prosthesis with guide Flange <br />D5935 <br />Mandibular resection prosthesis without guide Flange <br />D5936 <br />Obturator prosthesis, Interim <br />D5937 <br />Trismus appliance (not for TMD treatment) <br />D5951 <br />Feeding aid <br />D5952 <br />Speech aid prosthesis, pediatric <br />D5953 <br />Speech aid prosthesis, adult <br />D5954 <br />Palatal augmentation prosthesis <br />D5955 <br />Palatal lift prosthesis, definitive <br />D5958 <br />Palatal lift prosthesis, interim <br />D5959 <br />Palatal lift prosthesis, modification <br />D5960 <br />Speech aid prosthesis, modification <br />D5982 <br />Surgical stent <br />D5983 <br />Radiation carrier <br />D5984 <br />Radiation shield <br />D5985 <br />Radiation cone locator <br />D5986 <br />Fluoride gel carrier <br />D5987 <br />Commissure splint <br />D5988 <br />Surgical splint <br />D5999 <br />Unspecified maxillofacial prosthesis, by report <br />D6000 - D6199 IMPLANT SERVICES <br />D6010 Surgical placement of implant body: endosteal implant <br />D6012 Surgical placement of interim Implant body for transitional prosthesis: endosteal <br />implant <br />D6013 Surgical placement of mini Implant <br />CDT2018 (Eff. 01-01-18) <br />25C-83 <br />
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