Comprehensive Guide to D1353 Dental Code and Sealants

What ADA CDT dental code is D1353?

D1353 is the ADA CDT dental code for repairing a sealant. The code description is officially “sealant repair – per tooth.”

Frequently Asked Questions About D1353 Dental Code

What procedure does D1353 refer to?

This code covers the repair of a sealant on a tooth to restore its protective function.

What are the documentation requirements and best practices for D1353?

Documentation should include detailed notes on the tooth repaired, the condition of the original sealant, and the repair procedure performed.

What are the typical costs, reimbursement rates and guidelines for D1353?

Costs typically range from $20 to $50 per tooth, with reimbursement varying. It is often covered under preventive care benefits, particularly for children and adolescents.

Are there any common errors or pitfalls to avoid with D1353?

Common pitfalls include inadequate documentation of the original sealant condition and the repair procedure, leading to potential claim denials and lack of follow-up.

How should D1353 be submitted on an insurance claim, and should a site be included?

Submit with detailed notes on the tooth repaired, the condition of the original sealant, and the repair procedure performed. Site-specific details are typically required for each tooth repaired.

Is D1353 often used with other codes, and how does it fit into the overall coding system?

Often used with sealant codes like D1351 and periodic exam codes like D0120. It helps in maintaining the effectiveness of sealants by repairing any damage or wear.

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

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

What are the ethical considerations and common fraud indicators associated with D1353?

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

What are the key differences between similar codes?

D1353 is for sealant repairs, while D1351 is for new sealant applications. Use D1353 specifically for restoring the protective function of existing sealants.

Why was D1353 specifically used for my treatment, and are there alternative treatments with different codes and costs?

D1353 is used for repairing existing sealants. Alternatives include D1351 for new sealant applications, depending on the condition of the sealant and the patient’s needs.

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