Sealant Per Tooth - CDT Code Guide
Overview
CDT Code D1351 refers to the application of a dental sealant on a per-tooth basis. This preventive procedure involves the mechanical and/or chemical preparation of the enamel surface, followed by the application of a sealant to protect the tooth from decay. Sealants are typically applied to the chewing surfaces of the back teeth, where decay occurs most often. This procedure is commonly used in pediatric dentistry but is also applicable for adults at risk of cavities. The sealant acts as a barrier, protecting enamel from plaque and acids.
In clinical practice, sealants are often recommended for children and teenagers as their permanent molars come in. However, adults who have deep grooves and pits in their teeth may also benefit from sealants. The procedure is quick, painless, and can significantly reduce the risk of tooth decay, making it a valuable part of a comprehensive preventive dental care plan.
When to Use This Code
- When a child’s permanent molars have fully erupted and are at risk for decay.
- For adults with deep pits and fissures on their molars.
- In patients with a history of dental caries who are at increased risk for future decay.
- During routine dental visits when preventive care is discussed.
- For patients with limited access to regular dental care as a preventive measure.
Documentation Requirements
- Detailed chart notes indicating the tooth number and surfaces sealed.
- Patient consent for the procedure, noting understanding of benefits and risks.
- Clinical justification for the use of sealants, such as risk of decay.
- Documentation of the materials used for the sealant application.
- Record of patient education provided regarding the benefits of sealants.
- Follow-up recommendations for sealant maintenance and re-evaluation.
Billing Considerations
Sealants are typically covered by dental insurance for children and teenagers, often up to a certain age. Frequency limitations may apply, such as once every three to five years per tooth. It’s important to verify with the patient's insurance for specific coverage details. Common modifiers may include those indicating the specific tooth number. Ensure accurate documentation to support the necessity of the procedure.
Related CDT Codes
Frequently Asked Questions
Coverage for adults varies by insurance plan. It's best to verify with the patient's specific insurance provider.
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