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Guide for Dental Fees for Dental Specialists January 2019

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Guide for Dental Fees for Dental Specialists January 2019 Guide for Dental Fees for Dental Specialists January 2019 Copyright © 2018 by the Alberta Dental Association and College ALBERTA DENTAL ASSOCIATION AND COLLEGE PREAMBLE The fees listed herein are published to serve merely as a guide. No dentist receiving this list is under any obligation to accept the fees itemized. Any dentist who does not use all or any of these fees will in no way suffer in his/her relations with the Alberta Dental Association and College or any other body, group or committee affiliated with or under the control of the Alberta Dental Association and College. A genuine suggested fee guide is one which is issued merely for professional information purposes without raising any intention or expectation whatsoever that the membership will adopt the schedule for their practices. Dentists have the right and freedom to use any dental codes that are included in the Alberta Uniform System of Coding and List of Services. Dentists may use these recommended fees to assist them in determining their own professional fees. A suggested protocol to follow in order to eliminate the possibility of patient misunderstandings regarding the fees for dental treatment is: a. Perform a thorough oral examination for the patient. b. Explain, carefully, the particular problems encountered in this patient's mouth. Describe your treatment plan and prognosis, in a manner, which the patient can fully understand. Assure yourself that the patient has understood the presentation. c. Present your fee for treatment, before the commencement of treatment. d. Arrange financial commitments in such a manner that the patient understands his/her obligation. e. If there is any question as to why this fee must be charged ... explain at this time. f. Describe, explain and note any conditions, which may require an additional fee. g. For the patient who requires a removable prosthetic service, two pertinent points must be emphasized: 1. The length of time that adjustments will be provided, at no additional fee; and 2. Whether or not the initial fee includes the cost of necessary relines. h. In all areas of treatment, the fee you charge should be based on the skill, judgment and experience, which you have attained, and on the degree to which these are applied in the treatment of your patient. 0#4(]i 'UIDEº3TRUCTURE !5(]GXD%(NT]#TT74H(']#&&XP#U(=[]'(T&N7%(]U5(]MNJ&('XN(T]MNJY9'(']#H']#P(]'7Y7'(']7HUJ]Y#N8JXT &#U(4JN7(T]J+]T(PY7&(T]!5(]7G&?XT7JG]J+]#]&J'(]7H]#]&#U(4JP[]'J(T]GJU]N(TUP7&U]U5#U]MPJ&('XP(]UJ]# TM(&7.&]TM(&7#>U\ ]!5(]&=#TT7-;&#U8JH]7T]#T]-L=@JZT 9 &$./2&29 9 15.3&/.9 9 23/13&/.9 9 .//.3&29 9 1&//.3&29 9 1/23%//.3'29 -/6+9 9 1/23%//.3)29 &79 9 1+9.97&++/ &+941$189 9 13%//.3&29 9 *4.3&69.1+915(29 !5(]GXE%(QT]XT(']UJ]'(T&P7%(]#]T(QY7&(]EXTU]#&&XN#W(=[]&JG+KND]UJ]U5(]1@@JZ7H4]MN8G&7M=(T Z5(P(]U5( "1239&$&39 '(T74H#U(T]U6(] 3$/189/ 9216&9 2/.9&$&39 '(T74G#U(T]U5(] ,22'"3'/.9/ 9215&9 3%&19&$&39 '(T:4G#U(T]U5(] 4+22' )3&/.9/ 9215&9 #413%9&$&39 '(T74G#U(T]U5(] .1+9216&93&3+9/.+89 Z5(G]#MM=7&#%=( ] &!3%9&$&39 '(T74G#U(T]U5(] 0&"9215&9 7-0+ 99 N(MN(T(HUT]U5(]&#U(4JP[]N(TUJN#U7Y(] N(MN(T(GUT]U5(]&>#TT7/&#U8JH]#D#=4#D]N(TUJO#U:JGT] N(MN(T(HUT]U5(]TX% &>#TT:/&#U8JG]#D#?4#FT]M(NF#G(GU] '(GU7U:JG]N(MP(T(GUT]U5(]T(PY7&(]U7UA(]M(PD#G(HU]DJB#PT] R(MN(T(HUT]U5(]TM(&70&]T(NY7&(]M(PD#G(GU]EJC#PT]JG(]TXN,$&(] 0#4(]ii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ºiii Conversion forante1ior tooth coloured restorations fromthe G.V. Black classificationto the smface classification system: Class I One surfacerestoration Class ill One surfacerestoration, if not extended beyond the line angle. Two continuous surfacerestoration, if extended beyond the line angle. Class IV Three continuous smface restoration, (such as MIL,MIV or DIL, DIV), if not extended beyond the remaining line angle. Four continuous surfacerestoration ( e.g. MILV or DILV), if extended beyond the remaining line angles. Class IV Double Four surface restoration (e.g. MIDL or MILplus DIL), if not extended beyond the remaining line angles. Five smface restoration ( e.g. MIDLV or MIL plusV DIV), if extended beyond the remaining line angles. Class V One surface restoration Class VI One surface restoration (incisal), if not extended beyond the line angles Poste1ior Teeth Classification: A one surface posterior restoration is one in which the restoration involves only one of the five smface classifications (mesial, distal, occlusal, lingual, or facial, includingbuccal and labial). A two surface poste1ior restoration is one in which the restoration extends to two of the fivesurface classifications. A three surface posterior restoration is one in which the restoration extends to three of the five smfaceclassifications. A four surface posterior restoration is one in which the restoration extends to four of the five smfaceclassifications. A five surface or more posterior restoration is one in which both the lingual and facial margins extend beyond the line angle. 0#4(]iv l. One SurfaceRestoration, see figures 1, 2, and 3 CLASS I CLASS III (if not extended beyond the line angle) CLASSV Vestibular or Lingual CLASSVI Incisal Mesial Lingual Pit Vestibular (facial or labial) Figure2 Two Surface Continuous Restoration, see figure 4 2. lnterproximal and Vestibular CLASS III (if extended beyond the line angle due to ca1ies, vestibular or lingualin a continuous fashion) Figure4 This restoration 3. Three Surface Continuous Restoration, see figure5 includes incisal, vestibular, inter­ proximal (but not Three continuous smfaces such as MIL,MIV, DIL,or DIV, lingual) surfaces where the restoration does not extend past the remaining line angle. Four Surface Continuous Restoration (Typical Class IV), see figure 6 4. Extends both lingually and vestibularly as Four continuous smfaces, such as: MILV, or DILV,line well as restoring the angle. interproximal and incisal surfaces Figure6 5. Five SurfaceContinuous Restoration or Maximum Surfaces per Tooth, see figures 7 and 8 Five continuous smfaces such as: MIDLV or a combination of MILV and DILV together on the same tooth or Figure8 Figure7 0#4(]v Suite 402-7609 109 Street Edmonton AB T6G 1C3 T. 780 432 1012 f. 780 433 4864 www.DentalHealthAlberta.ca 2019 Uniform System of Coding and List of Services – Changes from 2018 Dental Specialists Guide Change Type Code Description Change Made Modifications New 01603 Examination and Diagnosis, Surgical, Comprehensive Examination described in code 01601 with the addition of craniofacial, neck and extremity New 01604 Examination described in code 01601, 01603 with the addition of Examination and Diagnosis Surgical Comprehensive Intensive Care Unit New 04314 Biopsy, Soft, Extraoral Tissue, Aspiration New 04315 Biopsy, Soft, Extraoral Tissue, Incision Edit 04800 VISUAL IMAGING, Removal of ‘’PHOTOGRAPHS’’ and DIAGNOSTIC (technical procedure only)’ Addition of ‘’VISUAL IMAGING’’ Deprecate 04801 Single photograph Deprecate 04802 Two photos Deprecate 04803 Three photos Deprecate 04809 Each additional photo over three New 04810 Photographs, diagnostic (technical procedure only) New 04811 Single photograph New 04812 Two photos New 04813 Three photos Page vi New 04819 Each additional photo over three New 04850 Maxillofacial Endoscopy (technical procedure and interpretation) New 04851 Direct laryngoscopy New 04852 Indirect laryngoscopy New 04853 Nasoendoscopy New 04854 Sinoendoscopy New 04855 Bronchoscopy New 04856 Esophagoscopy New 04857 Fundoscopy New 04858 Otoscopy New 04859 Sialoendoscopy New 05110 Virtual Surgical Planning for orthognathic and craniomaxillofacial surgery +E +L New 05111 One unit New 05112 Two units New 05113 Three units New 05114 Four units New 05119 Each additional unit over four Deprecated 12101 Fluoride Treatment, Foam, Gel or Rinse Deprecated 12102 Fluoride Treatment, Supervised, Self-Administered Brush-in Deprecated 12103 Fluoride Treatment, Varnish New 12110 Topical, whole mouth, in office New 12111 Rinse New 12112 Gel or Foam New 12113 Varnish New 12114 Self-administered brush-in, supervised Edit 27401 One crown +L Addition of +L Edit 27409 Each additional crown +L Addition of +L New 42850 Flapless Approach, with Osteoplasty/Ostectomy for Crown Lengthening New 42851 Per site Edit 43100 PERIONDAONTAL Removal of ‘’PROVISIONAL’’ Removal of SPLINT OR LIGATION, ‘’Note: This procedure is in addition to the INTRA CORNAL usual code for the tooth preparation on either side’’ Page vii Edit 43200 PERIODONTAL SPLINT Removal of ‘’PROVISIONAL’’ OR LIGATION, EXTRA CORONAL Edit 43270 Cast/Soldered/Ceramic/Pol Addition of “/Wire/Fiber Ribbon” ymer Glass/Wire/Fiber Ribbon, Splint Bonded Edit 43271 Indirect, Per abutment + L Addition of “ Indirect” Edit 43272 Direct, Per abutment + L Addition of “Direct” Edit 66300 Repairs, Re- Typo-REPARIS to REPAIRS Insertion/Recementation (+ L where laboratory charges are incurred during repair of bridge) Edit 67501 Retainer Made to an Existing Removal of ‘’Abutment Preparation Partial Denture Clasp Under’’.
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