Comprehensive Guide to D1352 Dental Code and PRRs

What ADA CDT dental code is D1352?

D1352 is the ADA CDT dental code for a preventive resin restoration (PRR). This is a conservative restoration of an active cavitated lesion in a pit or fissure that does not extend into the dentin. The code is officially known as “preventive resin restoration in a moderate to high caries risk patient – permanent tooth.”

Frequently Asked Questions About D1352 Dental Code

What procedure does D1352 refer to?

This code refers to the application of a preventive resin restoration to a tooth, particularly in patients with moderate to high caries risk.

What are the documentation requirements and best practices for D1352?

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

What are the typical costs, reimbursement rates and guidelines for D1352?

Costs typically range from $75 to $150 per tooth, with reimbursement varying. It is often covered under preventive care benefits for high caries risk patients.

Are there any common errors or pitfalls to avoid with D1352?

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

How should D1352 be submitted on an insurance claim, and should a site be included?

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

Is D1352 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 in patients with higher risk, particularly on occlusal surfaces.

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

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

What are the ethical considerations and common fraud indicators associated with D1352?

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

What are the key differences between similar codes?

D1352 is for preventive resin restorations, while D1351 is for sealants. Use D1352 specifically for high caries risk patients needing more extensive preventive measures.

Why was D1352 specifically used for my treatment, and are there alternative treatments with different codes and costs?

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

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