Technicians: How To Claim

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How to Claim
Use your own amounts for the various codes.

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	Indirect Crown



	Indirect Bridge Construction



	Indirect Anatomical Fibre Post



	Indirect Bridges – Retainers

INDRECT CROWN

Diagnostic codes: K02.1; K03.0; K03.9
Clinical code:
8409 +L (rule 007)
Lab codes:
9301 Model
9315 C&B Model
9319 Extra die
9320 Pindex
9327 x 2 Infection control
9330 Delivery charge (Max x4)
9557 Indirect comp cr/pontic
9758 Cost of fibre
9760 Cost of composite
Total Lab (8099)

INDRECT BRIDGE CONSTRUCTION

Diagnostic codes: K08.1/9 (congenital)
Clinical codes:
8437 (r007), pontic 8415 (r007) + L (Fee according to clinical code)
Lab codes:
9301 Model
9315 C&B Model
9319 Extra die
9320 Pindex
9327 x 2 Infection control
9330 Delivery charge
9524 Indirect comp inlay x 2 (or 9557 x 2)
9557 Indirect comp cr/pontic
9758 Cost of fibre
9760 Cost of composite
Total Lab (8099)

INDIRECT ANATOMICAL FIBRE POST

Diagnostic code: K04.2/3; K02.1/8
Clinical codes: 8391 + L (r007)

Lab codes (8099):
9301 Model
9315 C&B Model
9319 Extra die
9320 Pindex
9327 x 2 Infection control
9330 Delivery charge
9545 Post
9758 Cost of fibre post material
Total Lab (8099)
Total Clinical + Lab

Other applicable Clinical Codes:
8137 Emergency crown
8355 Direct composite veneer
8554 Lab resin veneer + L

Retainer full cover (crowns) code 8443 (r007) corresponding lab code 9557
Retainer Maryland: code 8617 corresponding lab code 9524, report pontic 8415 r007

Please also note that medical schemes have the right to limit the scope, the frequency and/or combinations of dental procedures that is covered or reimbursed. Certain medical schemes may require predetermination for particular procedures and/or when charges are expected to exceed a certain amount.