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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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D9950 Occlusion analysis - mounted case <br />D9951 Occlusal adjustment - limited <br />D9952 Occlusal adjustment - complete <br />D9970 Enamel mlcroabrasion <br />D9971 Odontoplasty 1-2 teeth; includes removal of enamel projections <br />D9972 External bleaching - per arch - performed in office <br />D9973 External bleaching - per tooth <br />D9974 Internal bleaching - per tooth <br />D9995 Teledentlstry - synchronous; real-time encounter <br />D9996 Teledentlstry - asynchronous; Information stored and forwarded to dentist for <br />subsequent review <br />D9999 Unspecified adjunctive procedure, by report <br />Note: This Appendix represents codes and nomenclature excerpted from the version of Current Dental <br />Terminology (CDT) in effect at the date of this printing. CDT coding and nomenclature are the <br />copyright of the American Dental Association, and have been accepted as the standard for data <br />transmission purposes under federal Administrative Simplification regulations. For the purposes of <br />this Appendix, Delta Dental's administration of Benefits, Limitations and Exclusions under this <br />Contract will at all times be based on the then -current version of CDT whether or not a revised <br />Appendix B Is provided. <br />CDT2018 (Eff. 01-01-18) <br />25C-91 <br />
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