INDEX Page 1 GENERAL GUIDELINES ................................................................................................................................... 5 INTRODUCTION TO THIS PUBLICATION ..................................................................................................................... 5 RULES .................................................................................................................................................................. 5 EXPLANATIONS ..................................................................................................................................................... 7 Additions, deletions and revisions ................................................................................................................ 7 Tooth identification........................................................................................................................................ 7 Treatment categories .................................................................................................................................... 7 Abbreviations used in the Schedule ............................................................................................................. 7 VAT ..................................................................................................................................................................... 7 I. GENERAL DENTAL PRACTITIONERS ...................................................................................................... 9 PREAMBLE ........................................................................................................................................................... 9 A. DIAGNOSTIC ................................................................................................................................................. 10 Clinical oral evaluations .............................................................................................................................. 10 Radiographs/Diagnostic Imaging ................................................................................................................ 11 Tests and laboratory examinations ............................................................................................................. 12 B. PREVENTIVE ................................................................................................................................................. 12 Dental prophylaxis ...................................................................................................................................... 12 Topical fluoride treatment (office procedure) .............................................................................................. 13 Other preventive services ........................................................................................................................... 13 Space maintenance (passive appliances) .................................................................................................. 14 C. RESTORATIVE ............................................................................................................................................... 14 Amalgam restorations (including polishing) ................................................................................................ 14 Resin restorations ....................................................................................................................................... 15 Gold foil restorations ................................................................................................................................... 15 Inlay/Onlay restorations .............................................................................................................................. 16 Crowns – single restorations ...................................................................................................................... 16 Other restorative services ........................................................................................................................... 17 D. ENDODONTICS .............................................................................................................................................. 19 Pulp capping ............................................................................................................................................... 19 Pulpotomy ................................................................................................................................................... 20 Endodontic therapy Endodontic retreatment .............................................................................................................................. 21 Apexification/recalcification procedures ..................................................................................................... 21 Apicoectomy/Periradicular services ............................................................................................................ 22 Other endodontic procedures ..................................................................................................................... 22 E. PERIODONTICS ............................................................................................................................................. 23 Surgical services......................................................................................................................................... 23 Adjunctive periodontal services .................................................................................................................. 23 Other periodontal services .......................................................................................................................... 24 F. PROSTHODONTICS (REMOVABLE ) .................................................................................................................. 25 Complete dentures ..................................................................................................................................... 25 Partial dentures ........................................................................................................................................... 25 Adjustments to dentures ............................................................................................................................. 25 Repairs to complete or partial dentures ...................................................................................................... 25 Denture rebase procedures ........................................................................................................................ 26 Denture reline procedures .......................................................................................................................... 26 Other removable prosthetic services .......................................................................................................... 26 G. MAXILLOFACIAL PROSTHETICS ...................................................................................................................... 26 H. IMPLANT SERVICES ....................................................................................................................................... 26 INDEX Page 2 Endosteal implants ..................................................................................................................................... 28 Eposteal implants ....................................................................................................................................... 28 Transosteal implants .................................................................................................................................. 28 I. PROSTHODONTICS , FIXED .............................................................................................................................. 29 Fixed partial denture pontics....................................................................................................................... 29 Fixed partial denture retainers – inlays/onlays............................................................................................ 29 Fixed partial denture retainers – crowns .................................................................................................... 29 J. MAXILLO -FACIAL AND ORAL SURGERY ............................................................................................................ 29 Extractions .................................................................................................................................................. 29 Surgical extractions .................................................................................................................................... 29 Other surgical procedures .......................................................................................................................... 30 Reduction of dislocation and management of other temporomandibular joint dysfunction ........................ 31 Repair of traumatic wounds ........................................................................................................................ 31 K. ORTHODONTICS ............................................................................................................................................ 31 L. ADJUNCTIVE GENERAL SERVICES .................................................................................................................