Comprehensive Guide to D1351 Dental Code and Sealants

What ADA CDT dental code is D1351?

D1351 is the ADA CDT dental code for placing sealants (per tooth). Sealants cover the top of teeth and fill deep grooves in order to prevent decay. The code description is officially “sealant – per tooth.”

Frequently Asked Questions About D1351 Dental Code

What procedure does D1351 refer to?

This code covers the application of a sealant to the chewing surface of a tooth to prevent decay.

What are the documentation requirements and best practices for D1351?

Documentation should include detailed notes on the tooth sealed, patient’s caries risk, and the procedure performed.

What are the typical costs, reimbursement rates and guidelines for D1351?

Costs typically range from $30 to $60 per tooth, with reimbursement varying. It is often covered under preventive care benefits for children and adolescents.

Are there any common errors or pitfalls to avoid with D1351?

Common pitfalls include inadequate documentation of the tooth sealed and patient’s caries risk, leading to potential claim denials and lack of follow-up.

How should D1351 be submitted on an insurance claim, and should a site be included?

Submit with detailed notes on the tooth sealed, patient’s caries risk, and the procedure performed. Site-specific details are typically required for each tooth sealed.

Is D1351 often used with other codes, and how does it fit into the overall coding system?

Often used with periodic exam codes like D0120 and prophylaxis codes like D1110. It helps in preventing decay on the chewing surfaces of molars and premolars.

How can I verify patient eligibility and coverage for this procedure?

Verify eligibility by contacting the patient’s insurance provider to ensure coverage for sealants under preventive care benefits.

What are the ethical considerations and common fraud indicators associated with D1351?

Maintain accurate and thorough records of the sealant application and findings to avoid fraud. Ensure the sealant is necessary and clinically justified.

What are the key differences between similar codes?

D1351 is for sealant applications, while D1352 is for preventive resin restorations (PRR). Use D1351 specifically for sealing the chewing surfaces of teeth to prevent decay.

Why was D1351 specifically used for my treatment, and are there alternative treatments with different codes and costs?

D1351 is used for sealant applications. Alternatives include D1352 for preventive resin restorations (PRR), depending on the patient’s caries risk and the condition of the tooth.

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