Can D1353 be used for both primary and permanent teeth?

Yes, D1353 can be applied to both primary and permanent teeth when sealant repair is necessary.

How often can sealant repair be billed?

Frequency limitations depend on the insurance policy. Some plans may allow repairs once every 12 months, while others may have different guidelines.

What materials are used in sealant repair?

Sealant repair typically involves the use of resin-based materials similar to those used in the initial sealant application.

Is patient consent required for sealant repair?

Yes, obtaining patient consent is a standard practice before performing any dental procedure, including sealant repair.

D1353

Sealant Repair Per Tooth - CDT Code Guide

Preventive/Other Preventive Services

Overview

CDT code D1353 refers to the procedure of repairing a dental sealant on a tooth. Sealants are protective coatings applied to the chewing surfaces of teeth, primarily molars, to prevent decay. Over time, these sealants can become worn or damaged, necessitating repair to maintain their protective function. This procedure involves cleaning the tooth surface, assessing the existing sealant, and applying additional sealant material to restore its integrity. Sealant repair is a crucial preventive measure, especially in pediatric dentistry, to ensure long-term oral health and prevent cavities.

When to Use This Code

When a previously applied sealant shows signs of wear or damage.
If there is partial loss of the sealant material on a tooth surface.
In cases where the sealant has chipped but the tooth remains decay-free.
When a patient has a history of high caries risk and sealant maintenance is necessary.
During routine dental check-ups when sealant integrity is assessed.

Documentation Requirements

Detailed chart notes indicating the tooth number and surface involved.
Clinical notes describing the condition of the existing sealant and reason for repair.
Documentation of the materials used for the sealant repair.
Patient consent for the procedure.
Photographic evidence of the sealant condition before and after repair, if possible.

Billing Considerations

When billing for D1353, it's important to note that some insurance plans may have frequency limitations on sealant repairs. It may be necessary to use modifiers if the repair is performed on the same day as other procedures. Always verify with the patient's insurance provider regarding coverage for sealant repairs, as policies can vary significantly.

Related CDT Codes

D1351 D1206 D1208 D1120 D1110

Frequently Asked Questions

Coverage for D1353 varies by insurance plan. It's advisable to check with the patient's insurance provider for specific coverage details.

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