Page 1
Used Under License by the DAO
All Rights Reserved
The DAC Procedure Codes - Masterlist(s)
© 1990 - 2017 The Denturist Association of Canada, All Rights Reserved
Effective February 1, 2017
THIS GUIDE OF SUGGESTED FEES IS PUBLISHED BY
THE DENTURIST ASSOCIATION OF ONTARIO FOR
THE BENEFIT OF INSURANCE COMPANIES AND THIRD PARTY BILLING
Phone: 905-238-6090 or 1-800-284-7311
Fax: 905-238-7090
Email: [email protected]
THE DENTURIST ASSOCIATION
OF ONTARIO (DAO)
NOTE:
THE GUIDE COVERS PROFESSIONAL SERVICES AND SUGGESTED FEES
RENDERED BY A LICENSED DENTURIST. THE FEES FOR PROCEDURES DESCRIBED
ARE NOT OBLIGATORY; EACH LICENSED DENTURIST IS EXPECTED TO DETERMINE
INDEPENDENTLY THE FEES THAT WILL BE CHARGED.
Website: www.denturistassociation.ca
Revised January 2017
© 1990 - 2017 The Denturist Association of Ontario
Page 2
Introduction
THE DENTURIST ASSOCIATION of ONTARIO (DAO) FEE GUIDE
The DAC PROCEDURE CODES
College of Denturists of Ontario
Services
The value of this service is in its effectiveness in replacing tooth function while preserving the oral tissues
supporting the prosthesis.
In fabricating removable prostheses, various steps and technical procedures are necessary in order to assure the
highest quality of service possible. Many different types of dentures can be fabricated, therefore the fees will vary
according to the technical procedures involved and the degree of skill required.
The work performed by a Denturist is based on the value of the service being provided. This fee schedule
establishes comparative norms for evaluating different prosthodontic services which enable the Denturist, patient
and insurance companies to better compare the value of service provided.
The Denturist Association of Ontario (the DAO) is committed to annually publishing and providing an up-to-date
DAO Fee Guide to our membership and collaborating with the insurance industry. Our annual Fee Guide is
copyrighted and available for use by DAO members only.
The DAO continues to work with The Denturist Association of Canada (The DAC) on any required annual updates
or other modifications to The DAC Procedure Codes Master List as part of our commitment to our members and
the profession. The many members of the DAO and The DAC rely upon the DAO's knowledge and enthusiasm to
advance the Fee Guide as technology changes.
As a member of the DAO, you are authorized and licensed to use this Fee Guide and to use and reproduce the
DAO Fee Guide and The DAC Procedure Codes as set out herein for your denturist services.
The Denturist Association of Ontario (the DAO) is licensed by The Denturist Association of Canada (The DAC) to
reproduce, use, display and distribute The DAC Procedure Codes in this Fee Guide. The DAC Procedure Codes
master list, as provided to the DAO, has been developed and maintained and is owned by The DAC, including any
and all intellectual property rights therein (© 1990 - 2017 The Denturist Association of Canada, All Rights
Reserved). As a member of the DAO, you are authorized and licensed to use this Fee Guide for your denturist
services.
The Regulated Health Professions Act, 1991 includes the profession of Denturism as one of the dental health
professions listed under the Act. The Denturism Act, 1991 defines the College of Denturists of Ontario
(CDO/College) as the self-governing regulatory body which oversees and governs the profession. The College
Council is comprised of licensed member Denturists, and members of the public. Denturists are one of 26 health
care professions recognized as self-regulating in the province of Ontario.
It is not an objective of the CDO to set the fees which are charged by Denturists. However, they can confirm
whether a practitioner is certified (licensed) with the College. Insurers and third party adjudicators wishing to
confirm the status of any Denturist submitting a claim should call the CDO at 416-925-6331 or 1-888-236-4326 or
visit their website at http://cdo.in1touch.org/.
Denturists are part of the dental health team which specifically provides denture care through independent
practitioners in the province of Ontario.
The quality of prosthodontic services offered by a Denturist contributes to the improvement of a patient's oral
health and quality of life.
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved2 of 33
Effective February 1, 2017
Page 3
Format:
Adjustments (LLLT) = Low Level Laser Therapy in conjunction with adjustment
ARM = Additional Repair Materials to be used in conjunction with repairs as required
Mouthguard type 3 = vacuum formed
Mouthguard type 4 = pressure laminate or injectable elastic acrylic resin
S.C. = Service Charge (Independent Charge)
1 unit of time = 15 minutes2 units of time = 30 minutes
3 units of time = 45 minutes4 units of time = 60 minutes
It is for each individual practitioner to determine what fee is appropriate for their units of
time.
+L = Variable lab fees. Effective January 1, 2016, Procedure Code 98889 formerly utilized
for Commercial Laboratory Fees, was inactivated from The DAC’s Masterlist of Procedure
Codes. Procedure Code 98888, formerly utilized for In-House Laboratory Fees, was
renamed and is now utilized as Laboratory Fees.
As a guideline for those codes that no longer have a defined Lab Fee, we have kept the
column named "ORIG" which makes reference to the suggested total original fee before
the above change was made in 2016. "ORIG" now includes the 3% fee increase for 2017.
Units of Time - UT: Some procedures listed in this Fee Guide are described in "Units of
Time - (UT)". Each unit of time is based on a 15 minute period of time, therefore:
Each additional unit of time (beyond 4 units of time) = 15 minutes.
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved3 of 33
Effective February 1, 2017
Page 4
IMPORTANT: See following 2 pages for examples of how to use Codes 71006 and 71007
IMPORTANT: See Appendix C for a complete set of examples of how to use these and
other codes and/or go to the DAO website: www.denturistassociation.ca, log-in as a Member, go to
'Services'.
NEW CODES FOR 2017
● Code 41145 for Reinforced Partial Maxillary Denture - Free-End or Tooth
Borne with or without clasps and/or rests. This partial is designed to be easily
added to or converted.
● Code 41146 for Reinforced Partial Mandibular Denture - Free-End or Tooth
Borne with or without clasps and/or rests. This partial is designed to be easily
added to or converted.
● Code 71006 for Maxillary Casting. This code is to be used when including
a Maxillary Casting to be fabricated by a commercial lab. Ensure you place the
cost of the Maxillary Casting under this code and not under code 98888. This
format only applies to a Maxillary Partial Denture.
● Code 71007 for Mandibular Casting. This code is to be used when
including a Mandibular Casting to be fabricated by a commercial lab. Ensure
you place the cost of the Mandibular Casting under this code and not under
code 98888. This format only applies to a Mandibular Partial Denture.
© 1990 - 2017 The Denturist Association of Ontario
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Effective February 1, 2017
Page 5
Code 71006
Date of Service Procedure Code Description Prof Fee Lab Fee Total
No Date 31320
Complete
Mandibular -
standard 709.00 425.00 1134.00
No Date 41114
Partial max.-free
end-standard 673.00 +L 673.00+L
1807.00+L
Date of Service Procedure Code Description Prof Fee Lab Fee Total
01/02/2017 31320
Complete
Mandibular -
standard 709.00 425.00 1134.00
01/02/2017 41114
Partial max.-free
end-standard 673.00 484.00 1157.00
2291.00
Please note:
OR
Date of Service Procedure Code Description Prof Fee Lab Fee Total
No Date 31320
Complete
Mandibular -
standard 709.00 425.00 1134.00
No Date 41114
Partial max.-free
end-standard 673.00 334.00 1007.00
No Date 71006 Maxillary Casting 150.00 150.00
2291.00
Date of Service Procedure Code Description Prof Fee Lab Fee Total
01/02/2017 31320
Complete
Mandibular -
standard 709.00 425.00 1134.00
01/02/2017 41114
Partial max.-free
end-standard 673.00 334.00 1007.00
01/02/2017 71006 Maxillary Casting 150.00 150.00
2291.00
Please note:
Total Fee Claimed
● How to submit the claim for the same treatment:
Total Fee Claimed
● This code is to be used when including a Maxillary Casting to be fabricated by a
commercial lab. Ensure you place the cost of the Maxillary Casting under Code 71006 and
not under Code 98888. This format only applies to a Maxillary Partial Denture.
● The date of service is now placed on the claim.
● How to submit the claim for the same treatment:
Total Fee Claimed
● The cost of the casting in this example is $150.00. That fee is added to your Lab Fee and
placed under the Lab Fee when submitting your claim.
● The date of service is now placed on the claim.
Complete Mandibular and Cast Partial Maxillary Dentures (New option)
● How to submit a Pre-d for a complete mandibular and cast maxillary partial:
Examples of Codes 71006 and 71007
Complete Mandibular and Cast Partial Maxillary Dentures (Existing Format)
● How to submit a Pre-d for a complete mandibular and cast maxillary partial:
Total Fee Claimed
© 1990 - 2017 The Denturist Association of Ontario
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Effective February 1, 2017
Page 6
Code 71007
Date of Service Procedure Code Description Prof Fee Lab Fee Total
No Date 31310
Complete Maxillary
- standard 572.00 341.00 913.00
No Date 41124
Partial mand.-free
end-standard 703.00 +L 703.00+L
1616.00+L
Date of Service Procedure Code Description Prof Fee Lab Fee Total
01/02/2017 31310
Complete Maxillary
- standard 572.00 341.00 913.00
01/02/2017 41124
Partial mand.-free
end-standard 703.00 503.00 1206.00
2119.00
Please note:
OR
Date of Service Procedure Code Description Prof Fee Lab Fee Total
No Date 31310
Complete Maxillary
- standard 572.00 341.00 913.00
No Date 41124
Partial mand.-free
end-standard 703.00 353.00 1056.00
No Date 71007 Mandibular Casting 150.00 150.00
2119.00
Date of Service Procedure Code Description Prof Fee Lab Fee Total
01/02/2017 31310
Complete Maxillary
- standard 572.00 341.00 913.00
01/02/2017 41124
Partial mand.-free
end-standard 703.00 353.00 1056.00
01/02/2017 71007 Mandibular Casting 150.00 150.00
2119.00
Please note:
● The date of service is now placed on the claim.
Complete Maxillary and Cast Partial Mandibular Dentures (New option)
● How to submit a Pre-d for a complete maxillary and cast mandibular partial:
Total Fee Claimed
● How to submit the claim for the same treatment:
Total Fee Claimed
● This code is to be used when including a Mandibular Casting to be fabricated by a
commercial lab. Ensure you place the cost of the Mandibular Casting under Code 71007 and
not under Code 98888. This format only applies to a Mandibular Partial Denture.
● How to submit a Pre-d for a complete maxillary and cast mandibular partial:
Total Fee Claimed
● How to submit the claim for the same treatment:
Total Fee Claimed
● The cost of the casting in this example is $150.00 each. That fee is added to the Lab Fee
and placed under the Lab Fee when submitting the claim.
● The date of service is now placed on the claim.
Complete Maxillary and Cast Partial Mandibular Dentures (Existing Format)
© 1990 - 2017 The Denturist Association of Ontario
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Effective February 1, 2017
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Examinations
Examinations Are Not Inclusive in the “Fees” and Are Billed Separately.
EXAMINATIONS CODE PROF LAB TOTAL
General Oral Examination 10010 119.00 119.00
Oral Pathology Screening 10015 32.00 32.00
Limited Exam - New Patient 10020 63.00 63.00
Limited Exam - Previous Patient 10030 57.00 57.00
Emergency/Specific nature 10104 63.00 63.00
Annual/Recall/Recare 10105 57.00 57.00
10115 S.C.
10120 68.00 40.00 108.00
ALL EXAMINATIONS REQUIRE APPROPRIATE CHARTING OF FINDINGS.
* SEE INTRODUCTION/FORMAT
Examination with mirror of hard and soft tissues including checking
of occlusion and appliances.
Examination and evaluation of a specific situation in a localized
area.
Radiographic Interpretation - 1 unit of time (UT)*
Diagnostic Cast Model Required in Conjunction with
Exams/per modelStudy model used for determining denture design, rest prep
locations, occlusal contact points, etc.
Oral exams are an integral part of denture services provided by Denturists. Patients are assessed through the
appropriate examination to determine what services are required prior to developing a treatment plan.
Oral examinations for new denture patients entails a comprehensive regulatory approved investigation and
documentation of the oral cavity.
Extensive examination of the pre-prosthetic, edentulous, or partially
edentulous mouth, visual, digital and mirror examination of the oral
structures, head and neck (including the TMJ & lymph nodes), oral
mucosa, lips, tongue, oral pharynx, salivary glands, musculature,
and other associated stomatognathic structures. Also included in
this exam is a detailed Medical, Dental & Prosthetic history to be
completed on a regulatory approved form including a thorough
charting of the oral structures.
Oral exam using high intensity fluorescent light to locate, assess and
determine differentiated tissues throughout the oral cavity (eg: oral
cancer). This device is to be used in addition to a digital, visual
screening.
Examination with mirror of hard and soft tissues including checking
of occlusion and appliances.
© 1990 - 2017 The Denturist Association of Ontario
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Effective February 1, 2017
Page 8
a) Impressions preliminary and finals
final impressions - to include custom tray and muscle molded final impression
b) Bite Registration/Occlusal Records must include:
face bow transfer
semi adjustable articulator
centric relation may be determined by bite block technique establish vertical relation
premium quality teeth (tooth form should be of cusp or lingual contact occlusal morphology)
premium quality acrylic material
c) Try-In
includes full wax try-in verify centric occlusion and vertical dimension
verify protrusive and lateral movements
verify aesthetics and phonetics
fitting of cast framework
d) Insertion
verify centric and eccentric relations
check for pressure spots and denture base extensions
provide oral hygiene instruction and patient denture education
provide 3 months post insertion care
e) Opposing model included where required
NOTE: Clinical Protocol is a minimum standard. If procedures and/or materials are modified, then the fees should be
adjusted accordingly.
DESCRIPTION of PROCEDURES for PRECISION-EQUILIBRATED DENTURES -
COMPLETE AND PARTIAL DENTURES
© 1990 - 2017 The Denturist Association of Ontario
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PRECISION EQUILIBRATED DENTURE(S) - COMPLETE CODE PROF LAB TOTAL
Complete Maxillary 31110 729.00 437.00 1166.00
Complete Mandibular 31120 898.00 538.00 1436.00
Complete Maxillary 31113 790.00 474.00 1264.00
Complete Mandibular 31123 970.00 583.00 1553.00
COMPLETE DENTURE(S)
COMPLETE OVERDENTURE(S) (over naturally retained roots)
© 1990 - 2017 The Denturist Association of Ontario
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CODE PROF LAB TOTAL ORIG
PARTIAL (CAST FRAME)
Partial Maxillary 41110 859.00 +L 859.00 +L 1289.00
Partial Mandibular 41120 901.00 +L 901.00 +L 1352.00
Altered cast impression / with above codes 41140 109.00 65.00 174.00
Partial Maxillary 41216 825.00 +L 825.00 +L 1238.00
Partial Mandibular 41226 867.00 +L 867.00 +L 1301.00
Partial Maxillary 41516 1033.00 +L 1033.00 +L 1549.00
Partial Mandibular 41526 1086.00 +L 1086.00 +L 1628.00
Altered cast impression / with above codes 41546 109.00 65.00 174.00
OVERDENTURE(S) CAST FRAME (over naturally retained roots)
PRECISION EQUILIBRATED DENTURE(S)
FREE-END CAST FRAME
TOOTH BORNE CAST FRAME
© 1990 - 2017 The Denturist Association of Ontario
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Effective February 1, 2017
Page 11
a) Impressions
preliminary and finals
finals to be muscle molded
b) Bite Registration
to include centric and vertical relations
tooth selection
must be mounted in an articulator
c) Try-In full wax try-in
verify centric occlusion and vertical dimensions
check aesthetics and phonetics
fitting of cast framework
d) Insertion
verify centric and eccentric movements
check for pressure spots and denture base extensions
provide oral hygiene instruction and patient denture education
provide 3 months post insertion care
e) Opposing model included where required
DESCRIPTION of PROCEDURES for STANDARD DENTURES - COMPLETE
AND PARTIAL DENTURES
NOTE: Suggested Clinical Protocol - Minimum standard of acceptable denture construction. If procedures
are modified, then the fees should be adjusted accordingly.
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved11 of 33
Effective February 1, 2017
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STANDARD DENTURE(S) - COMPLETE CODE PROF LAB TOTAL
Complete Maxillary 31310 572.00 341.00 913.00
Complete Mandibular 31320 709.00 425.00 1134.00
Complete Maxillary 31510 327.00 196.00 523.00
Complete Mandibular 31520 401.00 240.00 641.00
Complete Maxillary 31610 617.00 371.00 988.00
Complete Mandibular 31620 759.00 456.00 1215.00
COMPLETE DENTURE(S)
COMPLETE TRANSITIONAL DENTURE(S)
COMPLETE OVERDENTURE(S) (over naturally retained roots)
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STANDARD DENTURE(S) - PARTIAL (CAST FRAME) CODE PROF LAB TOTAL ORIG
Partial Maxillary 41114 673.00 +L 673.00 +L 1007.00
Partial Mandibular 41124 703.00 +L 703.00 +L 1056.00
Altered cast impression / with above codes 41144 109.00 65.00 174.00
Partial Maxillary 41254 647.00 +L 647.00 +L 970.00
Partial Mandibular 41264 678.00 +L 678.00 +L 1016.00
Partial Maxillary 41510 809.00 +L 809.00 +L 1213.00
Partial Mandibular 41520 850.00 +L 850.00 +L 1273.00
Altered cast impression / with above codes 41540 109.00 65.00 174.00
FREE-END CAST FRAME
TOOTH BORNE CAST FRAME
OVERDENTURE(S) CAST FRAME (over naturally retained roots)
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CODE PROF LAB TOTAL
Partial Maxillary 41610 531.00 318.00 849.00
Partial Mandibular 41620 560.00 336.00 896.00
Partial Maxillary 41710 374.00 224.00 598.00
Partial Mandibular 41720 393.00 236.00 629.00
Partial Maxillary 41810 617.00 371.00 988.00
Partial Mandibular 41820 650.00 389.00 1039.00
OVERDENTURE(S) WITH CLASPS (over naturally retained roots)
STANDARD DENTURE(S) PARTIAL ACRYLIC BASE - WITH
CLASPS
STANDARD WITH CLASPS
TRANSITIONAL WITH CLASPS
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CODE PROF LAB TOTAL
Partial Maxillary 41612 443.00 267.00 710.00
Partial Mandibular 41622 469.00 279.00 748.00
Partial Maxillary 41712 290.00 174.00 464.00
Partial Mandibular 41722 306.00 183.00 489.00
Partial Maxillary 41812 531.00 319.00 850.00
Partial Mandibular 41822 560.00 336.00 896.00
CODE PROF LAB TOTAL
Partial Maxillary 41145 540.00 360.00 900.00
Partial Mandibular 41146 570.00 380.00 950.00
STANDARD DENTURE(S) - PARTIAL RESILIENT BASE CODE PROF LAB TOTAL ORIG
Definition: Flexible (examples Flexite/Valplast)
Partial Maxillary 41914 435.00 +L 435.00 +L 695.00
Partial Mandibular 41924 456.00 +L 456.00 +L 729.00
STANDARD DENTURE(S) REINFORCED WITH ACRYLIC
BASE
FREE-END OR TOOTH BORNE WITH OR WITHOUT CLASPS AND/OR RESTS (This partial is designed to be
easily added to or converted.)
STANDARD DENTURE(S) PARTIAL ACRYLIC BASE - NO
CLASPS
STANDARD NO CLASPS (HEAT CURED)
TRANSITIONAL NO CLASPS (COLD CURED)
OVERDENTURE(S) NO CLASPS (over naturally retained roots)
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IMMEDIATE DENTURES CODE PROF LAB TOTAL ORIG
Precision Equilibrated Denture(s)
COMPLETE IMMEDIATE DENTURES
Complete Maxillary 31111 859.00 515.00 1374.00
Complete Mandibular 31121 1058.00 634.00 1692.00
COMPLETE IMMEDIATE OVERDENTURE(S) (over naturally retained roots)
Complete Maxillary 31114 937.00 561.00 1498.00
Complete Mandibular 31124 1151.00 690.00 1841.00
FREE-END CAST FRAME
Partial Maxillary 41111 1003.00 +L 1003.00 +L 1435.00
Partial Mandibular 41121 1055.00 +L 1055.00 +L 1506.00
TOOTH BORNE CAST FRAME
Partial Maxillary 41257 971.00 +L 971.00 +L 1389.00
Partial Mandibular 41267 1020.00 +L 1020.00 +L 1458.00
OVERDENTURE(S) CAST FRAME (over naturally retained roots)
Partial Maxillary 41517 1172.00 +L 1172.00 +L 1675.00
Partial Mandibular 41527 1231.00 +L 1231.00 +L 1759.00
Standard Dentures
COMPLETE IMMEDIATE DENTURES
Complete Maxillary 31311 672.00 404.00 1076.00
Complete Mandibular 31321 827.00 495.00 1322.00
COMPLETE IMMEDIATE TRANSITIONAL DENTURES
Complete Maxillary 31511 377.00 227.00 604.00
Complete Mandibular 31521 464.00 279.00 743.00
COMPLETE IMMEDIATE OVERDENTURE (over naturally retained roots)
Complete Maxillary 31611 733.00 439.00 1172.00
Complete Mandibular 31621 900.00 540.00 1440.00
FREE-END CAST FRAME
Partial Maxillary 41115 785.00 +L 785.00 +L 1123.00
Partial Mandibular 41125 825.00 +L 825.00 +L 1177.00
TOOTH BORNE CAST FRAME
Partial Maxillary 41215 758.00 +L 758.00 +L 1084.00
Partial Mandibular 41225 796.00 +L 796.00 +L 1137.00
Fees include 3 months post-insertion care. Fees do NOT include tissue conditioner and/or permanent reline.
Fees include 3 months post-insertion care. Fees do NOT include tissue conditioner and/or permanent reline.
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IMMEDIATE DENTURES CODE PROF LAB ORIG
OVERDENTURE(S) CAST FRAME (over naturally retained roots)
Partial Maxillary 41511 917.00 +L 917.00 +L 1309.00
Partial Mandibular 41521 963.00 +L 963.00 +L 1375.00
STANDARD ACRYLIC WITH CLASPS
Partial Maxillary 41611 602.00 358.00 960.00
Partial Mandibular 41621 631.00 380.00 1011.00
TRANSITIONAL ACRYLIC WITH CLASPS
Partial Maxillary 41711 424.00 253.00 677.00
Partial Mandibular 41721 446.00 267.00 713.00
OVERDENTURE(S) ACRYLIC WITH CLASPS (over naturally retained roots)
Partial Maxillary 41811 703.00 420.00 1123.00
Partial Mandibular 41821 736.00 442.00 1178.00
STANDARD ACRYLIC NO CLASPS
Partial Maxillary 41613 504.00 303.00 807.00
Partial Mandibular 41623 528.00 316.00 844.00
TRANSITIONAL ACRYLIC NO CLASPS
Partial Maxillary 41713 330.00 197.00 527.00
Partial Mandibular 41723 345.00 207.00 552.00
OVERDENTURE(S) ACRYLIC NO CLASPS (over naturally retained roots)
Partial Maxillary 41813 602.00 358.00 960.00
Partial Mandibular 41823 631.00 380.00 1011.00
On Implants
IMPLANT RETAINED/TISSUE SUPPORTED
To be converted at time of extractions
Complete Maxillary 31711 1557.00 1038.00 2595.00
Complete Mandibular 31721 1363.00 908.00 2271.00
SCREW RETAINED REMOVABLE ACRYLIC TRANSITIONAL
To be converted to screw retained at time of extractions
Complete Maxillary 31811 2271.00 1514.00 3785.00
Complete Mandibular 31821 2271.00 1514.00 3785.00
TOTAL
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RELINE(S) CODE PROF LAB TOTAL
Complete Maxillary 32110 157.00 94.00 251.00
Complete Mandibular 32120 169.00 101.00 270.00
Partial Maxillary 42116 169.00 101.00 270.00
Partial Mandibular 42126 181.00 108.00 289.00
Complete Maxillary 32215 141.00 83.00 224.00
Complete Mandibular 32225 153.00 91.00 244.00
Partial Maxillary 42210 149.00 89.00 238.00
Partial Mandibular 42220 163.00 97.00 260.00
Complete Maxillary 32316 95.00 58.00 153.00
Complete Mandibular 32326 102.00 62.00 164.00
Partial Maxillary 42316 102.00 61.00 163.00
Partial Mandibular 42326 108.00 66.00 174.00
Complete Maxillary 32418 132.00 79.00 211.00
Complete Mandibular 32428 142.00 83.00 225.00
Partial Maxillary 42418 140.00 82.00 222.00
Partial Mandibular 42428 148.00 89.00 237.00
Complete Maxillary 32410 132.00 79.00 211.00
Complete Mandibular 32420 142.00 83.00 225.00
Partial Maxillary 42416 140.00 82.00 222.00
Partial Mandibular 42426 148.00 89.00 237.00
LAB PROCESSED/FUNCTIONAL IMPRESSION
SELF-POLYMERIZED/LAB PROCESSED
CHAIRSIDE/TEMPORARY ACRYLIC
CHAIRSIDE/PERMANENT ACRYLIC
LIGHT CURED
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RELINE(S) CODE PROF LAB TOTAL
Complete Maxillary 32610 226.00 136.00 362.00
Complete Mandibular 32620 250.00 150.00 400.00
Complete Maxillary 32611 264.00 158.00 422.00
Complete Mandibular 32621 359.00 216.00 575.00
Partial Maxillary 42616 248.00 149.00 397.00
Partial Mandibular 42626 277.00 166.00 443.00
RELINE(S) WITH PERMANENT SOFT LINING CODE PROF LAB TOTAL
Complete Maxillary 32510 274.00 164.00 438.00
Complete Mandibular 32520 286.00 172.00 458.00
Partial Maxillary 42516 286.00 172.00 458.00
Partial Mandibular 42526 298.00 178.00 476.00
Complete Maxillary 32318 177.00 105.00 282.00
Complete Mandibular 32328 186.00 111.00 297.00
Partial Maxillary 42318 182.00 109.00 291.00
Partial Mandibular 42328 196.00 116.00 312.00
ON IMPLANTS - OVER BAR
ON IMPLANTS
LAB PROCESSED/FUNCTIONAL IMPRESSION
CHAIRSIDE/PERMANENT SOFT LINING
ON IMPLANTS - BALL/INDEPENDENT
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REBASE CODE PROF LAB TOTAL
Complete Maxillary 33117 214.00 130.00 344.00
Complete Mandibular 33127 230.00 137.00 367.00
Partial Maxillary 43116 233.00 139.00 372.00
Partial Mandibular 43126 253.00 152.00 405.00
Complete Maxillary 33218 298.00 176.00 474.00
Complete Mandibular 33228 328.00 196.00 524.00
Partial Maxillary 43218 309.00 185.00 494.00
Partial Mandibular 43228 349.00 208.00 557.00
Complete Maxillary 33219 331.00 199.00 530.00
Complete Mandibular 33229 371.00 222.00 593.00
Partial Maxillary 43219 347.00 207.00 554.00
Partial Mandibular 43229 371.00 222.00 593.00
Partial Maxillary* 46410 S.C.
Partial Mandibular* 46420 S.C.
DUPLICATE CODE PROF LAB TOTAL
Complete Maxillary 34116 135.00 80.00 215.00
Complete Mandibular 34126 144.00 87.00 231.00
Partial Maxillary 44110 149.00 89.00 238.00
Partial Mandibular 44120 161.00 96.00 257.00
* SEE INTRODUCTION/FORMAT
ON IMPLANTS - OVER BAR
REMAKE – PARTIALS (USING EXISTING FRAMEWORK)
LAB PROCESSED/FUNCTIONAL IMPRESSION
LAB PROCESSED/ACRYLIC (NO CASTING)
LAB PROCESSED/FUNCTIONAL IMPRESSION
ON IMPLANTS - BALL/INDEPENDENT
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved20 of 33
Effective February 1, 2017
Page 21
REMOUNT & EQUILIBRATION CODE PROF LAB TOTAL
Complete Maxillary 35110 96.00 58.00 154.00
Complete Mandibular 35120 102.00 62.00 164.00
Partial Maxillary 45110 104.00 63.00 167.00
Partial Mandibular 45120 110.00 68.00 178.00
Complete Maxillary 35210 60.00 39.00 99.00
Complete Mandibular 35220 63.00 41.00 104.00
Partial Maxillary 45210 66.00 43.00 109.00
Partial Mandibular 45220 69.00 46.00 115.00
WITH IMPRESSION & RESET
RESET ONLY
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved21 of 33
Effective February 1, 2017
Page 22
REPAIRS
CODE PROF LAB TOTAL
Complete Maxillary 36110 60.00 36.00 96.00
Complete Mandibular 36120 60.00 36.00 96.00
Partial Maxillary 46110 60.00 36.00 96.00
Partial Mandibular 46120 60.00 36.00 96.00
Complete Maxillary 36210 90.00 54.00 144.00
Complete Mandibular 36220 90.00 54.00 144.00
Partial Maxillary 46210 90.00 54.00 144.00
Partial Mandibular 46220 90.00 54.00 144.00
Partial Maxillary 46310 110.00 67.00 177.00
Partial Mandibular 46320 110.00 67.00 177.00
ADDITIONAL REPAIR MATERIALS CODE PROF LAB TOTAL ORIG
Required / no impression 71309 22.00 22.00
Required / no impression 71310 22.00 22.00
Required for articulation 71311 76.00 76.00
Retentive post 71312 49.00 49.00
New Tooth each 71313 22.00 22.00
Per denture 71314 37.00 37.00
Cast each 71008 +L 0.00 +L 45.00
Wrought each 71010 45.00 45.00
Gold cast each 71020 +L 0.00 +L 45.00
Gold wrought each 71021 +L 0.00 +L 45.00
Thermal elastic friction each 71030 +L 0.00 +L 56.00
Thermal elastic gasket per tooth 71031 +L 0.00 +L 105.00
Per denture 71315 42.00 42.00
Soldering 71316 +L 0.00 +L 89.00
Laser weld 71322 +L 0.00 +L 89.00
Wire mesh screening 72001 +L 0.00 +L 68.00
Fiber mesh 72002 +L 0.00 +L 115.00
Cast mesh palate 72008 +L 0.00 +L 118.00
Cast palate (solid) 72010 +L 0.00 +L 190.00
Wire bar/Lingual bar 72021 63.00 63.00
Mandibular cast base (solid) 72030 +L 0.00 +L 190.00
Mandibular cast mesh 72031 +L 0.00 +L 118.00
REINFORCEMENTS
REPAIR MODEL
OPPOSING MODEL - IMPRESSION
ADDITIONAL
MULTIPLE FRACTURE
CLASP
FLANGE
Note: Repairs may include additional codes from the "Adjunctive Services/Additional Repair Materials" sections (series 71000-
73000 codes). Repairs may also require the use of a Commercial Laboratory. Laboratory services may not always be available in
every Denturist's office. When necessary, these fees are to now be added to the total Lab Fee once treatment is completed. ALL
Lab costs are to be placed under Lab Fee (98888).
NO IMPRESSION
WITH IMPRESSION
ADDITIONS – TOOTH OR CLASP
NOTE: Fees are inclusive of an addition of one tooth or an addition of one clasp (if additional teeth and/or clasps are
required, utilize appropriate 70,000 series codes)
MATRIX
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved22 of 33
Effective February 1, 2017
Page 23
TISSUE CONDITIONING CODE PROF LAB TOTAL
Complete Maxillary 37110 60.00 60.00
Complete Mandibular 37120 64.00 64.00
Partial Maxillary 47110 64.00 64.00
Partial Mandibular 47120 70.00 70.00
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved23 of 33
Effective February 1, 2017
Page 24
ADJUSTMENTS CODE PROF LAB TOTAL
Complete Maxillary 38110 57.00 57.00
Complete Mandibular 38120 60.00 60.00
Partial Maxillary 48110 59.00 59.00
Partial Mandibular 48120 63.00 63.00
Complete or Partial Adjustment (one unit of
time)*
58110 59.00 59.00
ADJUSTMENTS (LLLT) CODE PROF LAB TOTAL
Complete Maxillary 38111 88.00 88.00
Complete Mandibular 38121 94.00 94.00
Partial Maxillary 48111 94.00 94.00
Partial Mandibular 48121 99.00 99.00
* SEE INTRODUCTION/FORMAT
PER VISIT
PER VISIT
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved24 of 33
Effective February 1, 2017
Page 25
ADJUNCTIVE SERVICES CODE PROF LAB TOTAL ORIG
Treatment not specified* as required 70000 S.C.
Cancelled appointment per appointment 70010 56.00 56.00
Out of office/House call* per visit 70020 S.C.
Travelling expense* per visit and/or
mileage
70030 S.C.
Emergency Office visit after hours 70040 56.00 56.00
Professional consultation per session 70050 59.00 59.00
Written report each 70060 56.00 56.00
Court appearance* per appearance 70080 S.C.
Name in denture per denture 70150 54.00 54.00
Prophylaxis & polish per denture 70160 54.00 54.00
Replace worn posteriors per denture 70170 212.00 128.00 340.00
Surgical stent maxillary 70201 153.00 +L 153.00 +L 245.00
Surgical stent mandibular 70202 153.00 +L 153.00 +L 245.00
Surgical template maxillary 70208 75.00 +L 75.00 +L 119.00
Surgical template mandibular 70209 75.00 +L 75.00 +L 119.00
Mouth guard type 3 * per arch 70210 70.00 41.00 111.00
Mouth guard type 4 * per arch 70218 106.00 +L 106.00 +L 171.00
Occlusal plane per arch 70220 75.00 44.00 119.00
Occlusal treatment splints per arch 70230 200.00 119.00 319.00
Palatal/Lingual bar (new denture) per arch 70240 110.00 110.00
Anti-snoring device (adjustable anterior
mandibular positioner) 70250 713.00 +L 713.00 +L1139.00
Teeth Whitening per arch (+cost of
kit) 70260 133.00 79.00 212.00
Oral hygiene instruction per visit 70308 72.00 72.00
Treatment of TMJ disorders* per session 70310 S.C.
T.E.N.S.* per application 70340 S.C.
Mandibular Kinesiograph* each photo 70360 S.C.
Non-Specific diagnosis and/or treatment* 70370 S.C.
Maxillary Casting each 71006 +L 0.00 +L
Mandibular Casting each 71007 +L 0.00 +L
Precision attachments partial 71040 260.00 260.00
Overdenture complete or partial 71050 260.00 260.00
Mandibular – sublingual 71070 269.00 269.00
71075 241.00 145.00 386.00
71076 241.00 145.00 386.00
71073 430.00 430.00
* SEE INTRODUCTION/FORMAT
ATTACHMENTS
DENTURE STABILIZER SYSTEM
BITE REGISTRATION DEVICES
Intraoral Pin Tracing Device (for bite registration)
Face-bow Transfer (for articulation)
Extra or intra oral electronic tracings of TMJ using
software/electronic guided device that registers the protrusive and
laterotrusive excursion movements of the TMJ
SERVICES
CASTINGS
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved25 of 33
Effective February 1, 2017
Page 26
ADJUNCTIVE SERVICES (cont'd) CODE PROF LAB TOTAL ORIG
Impact resistant acrylic per denture 72040 118.00 118.00
Injection processed acrylic per denture 72041 211.00 211.00
Non-acrylic denture base (nylon, vinyl,
composite)*
per denture 72044 +L S.C. +L
Non-acrylic denture base (thermo-flex nylon)* per denture 72045 +L S.C. +L
Metal posteriors per denture 72050 +L 0.00 +L 118.00
Cutter bars per denture 72051 +L 0.00 +L 123.00
Backings/facings per tooth 72060 +L 0.00 +L 53.00
Soft-lining new denture 73008 186.00 186.00
Soft-lining - elastic gasket per tooth 73012 53.00 53.00
Soft-lining rebase 73013 186.00 186.00
Custom tray per arch 73019 76.00 76.00
Clear palate maxillary 73020 138.00 138.00
Gingival toning per denture 73030 118.00 118.00
Gold inlays per surface 73040 +L 0.00 +L 138.00
Amalgam inlays per surface 73041 +L 0.00 +L 138.00
* SEE INTRODUCTION/FORMAT
MATERIALS
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved26 of 33
Effective February 1, 2017
Page 27
Date of Service Procedure Code Description Prof Fee Lab Fee Total
No Date 31110
Complete Maxillary
- Precision 0.00 437.00 1166.00
No Date 31720
Complete
Mandibular 0.00 824.00 2060.00
No Date 74085
New Dentures (Placing
Components) 0.00 250.00 665.00
No Date 74085
New Dentures (Placing
Components) 0.00 250.00 665.00
4556.00
Date of Service Procedure Code Description Prof Fee Lab Fee Total
01/02/2017 31110
Complete Maxillary
- Precision 0.00 437.00 1166.00
01/02/2017 31720
Complete
Mandibular 0.00 824.00 2060.00
01/02/2017 74085
New Dentures (Placing
Components) 0.00 250.00 665.00
01/02/2017 74085
New Dentures (Placing
Components) 0.00 250.00 665.00
4556.00
Please note:
Total Fee Claimed
● If aditional implant components or lab fabricated parts are needed, that cost should be
added under code 98888.
● The date of service is now placed on the claim.
Example of Implant Retained/Tissue Supported with Indepdendent Attachments
Complete Maxillary and Complete Mandibular Dentures Retained by 2 Locators
● How to submit a Pre-d for a complete maxillary and complete mandibular:
Total Fee Claimed
● How to submit the claim for the same treatment:
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved27 of 33
Effective February 1, 2017
Page 28
Note: +L may include implant components as well as other +L fabricated parts. For example:
This Section may include but is not limited to the following individual implant abutments/attachments:
Locators, Equators, Ball & Cap, SFI™, etc.
CODE PROF LAB TOTALCOMPLETE DENTURES
Complete Maxillary 31710 1421.00 948.00 2369.00
Complete Mandibular 31720 1236.00 824.00 2060.00
PARTIAL DENTURES
Partial Maxillary 41601 1545.00 1030.00 2575.00
Partial Mandibular 41602 1360.00 906.00 2266.00
RELINES
Complete Maxillary 32610 226.00 136.00 362.00
Complete Mandibular 32620 250.00 150.00 400.00
Partial Maxillary 42616 248.00 149.00 397.00
Partial Mandibular 42626 277.00 166.00 443.00
REBASE
Complete Maxillary 33218 298.00 176.00 474.00
Complete Mandibular 33228 328.00 196.00 524.00
Partial Maxillary 43218 309.00 185.00 494.00
Partial Mandibular 43228 349.00 208.00 557.00
REPAIRS WITH IMPRESSION
Complete Maxillary 36410 117.00 78.00 195.00
Complete Mandibular 36420 117.00 78.00 195.00
REPAIRS NO IMPRESSON
Complete Maxillary 36310 87.00 58.00 145.00
Complete Mandibular 36320 87.00 58.00 145.00
Denture Reinforcements, Abutments, Processing Kits, Impression Copings, Impression Analogs, Verification Jigs, Duplication
of Master model with silicone material, etc.
IMPLANT RETAINED/TISSUE SUPPORTED WITH INDEPENDENT ATTACHMENTS
Implant retained/tissue supported dentures are often referred to as Implant retained or tissue supported - they are the
same thing.
Note: It is recommended that all Members receive specialized implant training and retain documentation of this training
prior to starting implant cases.
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved28 of 33
Effective February 1, 2017
Page 29
CODE PROF LAB TOTAL
NEW DENTURES
To be charged for each implant that the new
denture(s) are secured to.
Processing/placing of components are to be
changed at the time of new denture. 74085 415.00 250.00 665.00
RETROFITTING/RELINE BALL/CAP, LOCATOR/INDEPENDENT ABUTMENT
To be charged for each implant when an
existing denture is retrofitted/relined to
implants. Per Implant/Attachment 74090 415.00 250.00 665.00
RETROFITTING/RELINE BAR AND CLIP
To be charged for each implant when an
existing denture is retrofitted/relined to
implants. Per Implant/Attachment 74091 415.00 250.00 665.00
REPLACING IMPLANT COMPONENTS
The replacement of nylon, plastic inserts in
implant secured existing dentures. Fee is per
unit being replaced when worn out. Per Implant/Attachment 74095 34.00 0.00 34.00
IMPLANT RETAINED/TISSUE SUPPORTED WITH
INDEPENDENT ATTACHMENTS
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved29 of 33
Effective February 1, 2017
Page 30
Date of Service Procedure Code Description Prof Fee Lab Fee Total
No Date 31810 Complete Maxillary 1607.00 1071.00 2678.00
No Date 74016 Milled Bar +L
No Date 74085
New Dentures (Placing
Components) 415.00 250.00 665.00
No Date 74085
New Dentures (Placing
Components) 415.00 250.00 665.00
No Date 74085
New Dentures (Placing
Components) 415.00 250.00 665.00
No Date 74085
New Dentures (Placing
Components) 415.00 250.00 665.00
No Date 31120
Complete
Mandibular -
Precision 0.00 538.00 1436.00
6774.00+L
Date of Service Procedure Code Description Prof Fee Lab Fee Total
No Date 31810 Complete Maxillary 1607.00 1071.00 2678.00
No Date 74016 Milled Bar 3500.00 3500.00
No Date 74085
New Dentures (Placing
Components) 415.00 250.00 665.00
No Date 74085
New Dentures (Placing
Components) 415.00 250.00 665.00
No Date 74085
New Dentures (Placing
Components) 415.00 250.00 665.00
No Date 74085
New Dentures (Placing
Components) 415.00 250.00 665.00
No Date 31120
Complete
Mandibular -
Precision 898.00 538.00 1436.00
10274.00
Please note:
● How to submit the claim for the same treatment:
Total Fee Claimed
● If aditional implant components or lab fabricated parts are needed, that cost should be
added under code 98888.
● The date of service is now placed on the claim.
Example of Implant Bar Overdenture
Complete Maxillary on 4 Implants (Milled Bar) and Complete Mandibular
● How to submit a Pre-d for a complete maxillary and complete mandibular:
Total Fee Claimed
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved30 of 33
Effective February 1, 2017
Page 31
Note: +L may include all components as well as other +L fabricated parts. For example:
This Section may include but is not limited to the following implant bar designs:
Milled Bar, Cast Bar, SFI/Bar™, etc.
CODE PROF LAB TOTAL
COMPLETE DENTURES
Complete Maxillary 31810 1607.00 1071.00 2678.00
Complete Mandibular 31820 1607.00 1071.00 2678.00
RELINES
Complete Maxillary 32611 264.00 158.00 422.00
Complete Mandibular 32621 359.00 216.00 575.00
REBASE
Partial Maxillary 43219 347.00 207.00 554.00
Partial Mandibular 43229 371.00 222.00 593.00
REPAIRS WITH IMPRESSION
Complete Maxillary 36410 117.00 78.00 195.00
Complete Mandibular 36420 117.00 78.00 195.00
REPAIRS NO IMPRESSION
Complete Maxillary 36310 87.00 58.00 145.00
Complete Mandibular 36320 87.00 58.00 145.00
REMOVAL OF BAR PROSTHESIS
To be reinserted
One unit of time 74054 67.00 67.00
Two units of time 74154 134.00 134.00
Three units of time 74254 201.00 201.00
Four units of time 74354 268.00 268.00
Each additional unit of time over four 74454 67.00 67.00
REMOVAL OF BAR PROSTHESIS FOR PROPHYLAXIS
Complete Maxillary 74028 187.00 111.00 298.00
Complete Mandibular 74029 187.00 111.00 298.00
RETENTIVE BAR PREFABRICATED OR CUSTOM BAR
To be ordered/or prescribed by Denturist* 74016 +L S.C +L
NEW DENTURES
To be charged for each implant that the new
denture(s) are secured to.
Processing/placing of components are to be
changed at the time of new denture. 74085 415.00 250.00 665.00
REPLACING IMPLANT COMPONENTS
The replacement of nylon, plastic inserts in
implant secured existing dentures. Fee is per
unit being replaced when worn out. Per
Implant/Attachment 74095 34.00 0.00 34.00
* SEE INTRODUCTION/FORMAT
Denture Reinforcements, Abutments, Impression Copings, Impression Analogs, Verification Jigs, Screws, etc.
IMPLANT BAR OVERDENTURE
Note: It is recommended that all Members receive specialized implant training and retain documentation of this training
prior to starting implant cases.
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved31 of 33
Effective February 1, 2017
Page 32
Date of Service Procedure Code Description Prof Fee Lab Fee Total
No Date 74024 Complete Maxillary 5994.00 3597.00 9591.00
No Date 74016 Milled Bar +L +L
9591.00+L
Date of Service Procedure Code Description Prof Fee Lab Fee Total
01/02/2017 74024 Complete Maxillary 5994.00 3597.00 9591.00
01/02/2017 74016 Milled Bar 3500.00 3500.00
13091.00
Please note:
Total Fee Claimed
● If aditional implant components or lab fabricated parts are needed, that cost should be
added under code 98888.
● The date of service is now placed on the claim.
Example of Implant Supported Screw Retained Removable Prosthesis
Complete Maxillary (Occluding with Natural Lower Dentition)
● How to submit a Pre-d for a complete maxillary:
Total Fee Claimed
● How to submit the claim for the same treatment:
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved32 of 33
Effective February 1, 2017
Page 33
Note: +L may include all components as well as other +L fabricated parts. For example:
Denture Reinforcements, Abutments, Impression Copings, Impression Analogs, Verification Jigs, Screws, etc.
CODE PROF LAB TOTAL
COMPLETE DENTURES WITH ACRYLIC TEETH
Complete Maxillary 74024 5994.00 3597.00 9591.00
Complete Mandibular 74025 6241.00 3744.00 9985.00
COMPLETE DENTURES WITH PORCELAIN TEETH
Complete Maxillary 74026 6241.00 3744.00 9985.00
Complete Mandibular 74027 6241.00 3744.00 9985.00
RELINES
Complete Maxillary 32611 264.00 158.00 422.00
Complete Mandibular 32621 359.00 216.00 575.00
REPAIRS WITH IMPRESSION
Complete Maxillary 36410 117.00 78.00 195.00
Complete Mandibular 36420 117.00 78.00 195.00
REPAIRS WITH NO IMPRESSION
Complete Maxillary 36310 87.00 58.00 145.00
Complete Mandibular 36320 87.00 58.00 145.00
REMOVAL OF SCREW RETAINED PROSTHESIS
To be reinserted
One unit of time 74054 67.00 67.00
Two units of time 74154 134.00 134.00
Three units of time 74254 201.00 201.00
Four units of time 74354 268.00 268.00
Each additional unit of time over four 74454 67.00 67.00
REMOVAL OF SCREW RETAINED PROSTHESIS FOR PROPHYLAXIS
Complete Maxillary 74028 187.00 111.00 298.00
Complete Mandibular 74029 187.00 111.00 298.00
RETENTIVE BAR REPFABRICATED OR CUSTOM BAR
To be ordered/or prescribed by Denturist* 74016 +L S.C. +L
* SEE INTRODUCTION/FORMAT
IMPLANT SUPPORTED SCREW RETAINED REMOVABLE PROSTHESIS
Note: It is recommended that all Members receive specialized implant training and retain documentation of this training
prior to starting implant cases.
© 1990 - 2017 The Denturist Association of Ontario
All Rights Reserved33 of 33
Effective February 1, 2017
Page 34
A. Denturist Association of Ontario – ORAL HEALTH CHART
Date: Patient’s Name (or case #):
Oral Health Care Team
Denturist’s Name:
Dentist’s Name:
Consultants Name (i.e. - oral surgeon, periodontist, etc.):
Other (i.e. – commercial lab, implant company, etc):
Lesions, abnormalities, tooth mobility, special considerations:
12 11 21 22
13 23
14 24
15 25
16 26
17 MAXILLA 27
18 28
48 38
47 MANDIBLE 37
46 36
45 35
44 34
43 33
42 41 31
32
18 17 16 15 14 13 12 11 21 22 23 24 25 26 27 28
48 47 46 45 44 43 42 41 31 32 33 34 35 36 37 38
Page 35
1
B. RECOGNIZED RECORDING SHORT-FORMS
The Denturist Association of Ontario (DAO)recognizes that keeping very thorough patient records may be considered time consuming by some, yet the value and necessity of doing so over-rides such concerns. In an effort to assist members in satisfying their obligations to meet standards for record keeping the DAO recommends that members consider the use of accepted short forms for recording many procedures, findings, materials and treatments. The short-forms listed below may serve as a key/legend for members who wish to use these abbreviations. Short-forms developed by members individually are acceptable so long as they can reasonably be understood by someone else reviewing the patient health/dental record and so long as they are used consistently.
Record Keeping Short-Forms Record Keeping Short-Forms continued
Descriptive Terms Abbreviation Health Care Providers Abbreviation
Anterior ant. Denturist DD
Posterior post. Dentist DDS
Left lt. Dental Hygienist RDH
Right rt. Dental Technician DT / RDT
Distal dis. Chiropractor Chiro.
Mesial mes. Physician MD
Lingual ling. Buccal buc. Miscellaneous Abbreviation
Palatal pal. Required req’d
Labial lab. Lower ./l
Lip Support l.s. Upper u/.
Smile Line sm.ln. Upper & Lower u/l
Vertical Dimension v.d. Patient Pt.
Class I Occlusion Cls. I No Charge n/c
Class II Occlusion Cls. II No Show N/S
Class III Occlusion Cls. III Division Div Dental Materials Abbreviation
Crossbite X/B Alginate alg
Sore Spot SS Vinyl polysiloxane VPS
Border Molding BM
Bite Block BB
Procedures Abbreviation Pressure Indicating Paste pip
Reline rel Poly Ether PE
Rebase reb Zinc Oxide ZOE
Adjustment adj Impression imp Dental Charting Key / Legend Bite Registration Bite reg Descriptive Terms Abbreviation
Selection sel Missing Tooth X
Soft Liner Srel Unerupted / Impacted Circle tooth
Insertion ins. Drift & Migration Repair rep. Diastema II (between teeth)
Preliminary Impressions prelim Rotation Temporary Soft Liner tsl Sight Tooth Mobility (1mm) M1
Tissue Conditioner t/c Moderate Tooth Mobility (2mm) M2
Post Insertion Check-up PIC / PI√ Severe Tooth Mobility (3mm) M3
Will Call Us wcu Very Severe Tooth Mobility (+3mm) M (#mm)
Watch and Wait w/w Follow up f/u Restorations Abbreviation
Try In T/I Amalgam AG
Composite Resin CR
Types of Prostheses Abbreviation Porcelain Bonded to Metal CV
Acrylic Partial Upper Denture apud Porcelain Crown PC
Acrylic Partial Lower Denture apld Porcelain Onlay / Inlay PO / PI
Cast / Chrome Partial Upper Denture cpud Porcelain Veneer PV
Cast / Chrome Partial Lower Denture cpld Gold Crown GC
Complete Upper Denture cud Gold Onlay / Inlay GO / GI
Complete Lower Denture cld Stainless Steel Crown SSC
Immediate Denture Imm. Crown & Bridge C/B
NOTE: When performing adjustments, the specification of the location and nature of the adjustment is required.
Page 36
2
In the event of misunderstanding by a patient, or if legal questions should arise, the patient’s medical / dental record can prove invaluable in a member’s defense if charts and patients’ medical / dental records are thorough and complete
All charting must be done in ink. George Brown College has recommended that practitioners consider the use of multiple ink colours for partial denture designs such as red ink to indicate rests and blue ink to designate designs. While members might find multi-colour charting both useful and more readable, it is not mandatory to do so.
Any finding should be noted in the patient’s medical / dental record where the denturist believes that the finding may be significant to the outcome of the case. Missing or misplaced teeth must be charted. Abnormal surfaces of teeth should also be noted where the abnormality may effect the success of treatment. Such abnormalities should be tracked over time in order to reflect retrogressive changes, such as Attrition, Abrasion, Erosion, Resorption and Discolouration.
The clinical mobility of teeth provides a method of determining the presence or absence of supporting bone for the root or roots of the teeth. Mobility of teeth is referred to by a numerical index related to millimeters of tooth movement within the socket. It is highly recommended that changes in tooth mobility be tracked over time.
Members should chart what restorative treatments have been performed by other care providers in circumstances where the case design may have effects on the natural dentition, for example clasping crowns or heavily restored teeth.
The outcome and success of treatment can be measured by comparing the findings of initial examinations with the findings of periodic / regular follow-up examinations.
Patient health records provide a means of communication between the health team as well as with the patient. Comprehensive health histories, informed consent forms and accurate documentation are essential to the operation of a safe, thorough and patient focused practice. Health records are both business and legal documents that can serve as protection for the health care provider should concerns regarding care and treatment arise at a later date. Radiographs, study casts and all other documentation collected during the initial examination and during continued care are official parts of the patient’s medical / dental record.
A filing system is needed that has accessibility to the health records by authorized personnel only. The privacy of patient records must be maintained.
These abbreviations have been compiled from several sources including George Brown College, Clinical
Practice of the Dental Hygienist by Esther Wilkins (8th Edition), and the Federation Dentaire Internationale Identification System.
Sample charting for natural dentition:
Page 37
C. SUBMITTING ESTIMATES AND CLAIMS
1. The below changes were made effective January 1, 2016 and were included in the 2016 DAO Fee Guide. We are including the explanations from The DAC regarding these changes for your information. If you have questions/concerns please call the DAO office or email to: [email protected] .
The DAC together with its Procedure Code Committee announced that the Procedure Code 98889, formerly utilized for Commercial Laboratory Fees, has been inactivated from The DAC’s Masterlist of Procedure Codes and the Procedure Code 98888, formerly utilized for In-House Laboratory Fees, is renamed and utilized as Laboratory Fees effective January 1, 2016.
As of January 1, 2016 Denturists across Canada are required to submit pre-determinations to insurance companies as follows:
Professional Fee with Laboratory Fee outlined for Procedure Codes with no variable laboratory fee
Example: COMPLETE DENTURE(S)
Code Procedure Prof Lab Total
31310 - Complete Maxillary $572.00 $341.00 $913.00
Professional Fee with +L designation for Procedure Codes with variable laboratory fees i.e. +L is the total laboratory fee, the fee guides would use the designation +L for the lab component for procedure codes with variable laboratory fees - example below for ease of reference. This process will replace the +CL process that was previously used by Denturists when submitting procedure codes with variable laboratory fees using 2 separate laboratory fee procedure codes i.e. in-house lab 98888 and commercial lab 98889 Example: PARTIAL DENTURE(S)
Code Procedure Prof Lab Total
41114 - Partial Maxillary Free End $673.00 +L $673.00 +L
Thus example 2 would be not to include a dollar figure for the laboratory fee in the fee guides that are provided to the insurance industry for the procedure codes with a variable laboratory fee only (i.e. the current procedures that have
+CL). These procedures would have the professional fee with the designation +L.
The DAC feels that by not having a defined laboratory fee stated in the fee guides, for procedure codes with variable laboratory fees, there would be no conflicting dollar values between the laboratory fee in the insurer's systems and the laboratory fee submitted in the claim by the Denturist.
CLHIA (Canadian Life and Health Insurance Association) members did point out that insurers set maximum reasonable and customary (R&C) limits for laboratory fee charges based on a % of the professional fee and that, by combining two fees into one field, the maximum R&C limit may be reached more frequently, thereby increasing patient out-of-pocket costs. The DAC explained that in cases where there is a variable laboratory fee that would cause the laboratory fee to exceed the R&C, Denturists would utilize the necessary 70,000 series procedure codes, which would allow for the proper adjudication of Denturist claims in order to be fair to dental insurance subscribers and equitable to the professions of Denturism and Dentistry. This will alleviate a lot of paperwork and unnecessary administrative hours on all parties involved.
When preparing to send in the claim once treatment is completed Denturists would add any additional Lab cost to the total Lab fee under code 98888. It is advisable to keep any proof of lab costs in the patient's chart. We also added the column named “ORIG” that makes reference to the total original fee from the 2016 Fee Guide. It will only be with the codes that no longer have a Lab Fee defined.
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C. SUBMITTING ESTIMATES AND CLAIMS (cont’d)
It is recommended that a treatment plan should be supplied to the patient in advance of treatment being rendered and the patient should receive written confirmation of insurance carrier liability before treatment begins. Please keep the following points in mind when submitting estimates /pre-determinations (pre-d):
do not enter a date of service on estimates, it leads the insurer to believe that a service has been completed;
do not sign an estimate form; do not submit a claim and an estimate on the same form e.g. if you are submitting a claim for a new patient
exam and an estimate for new dentures, submit the claim for the exam on one form and the estimate for new dentures on a second form;
clearly indicate on the form ‘for pre-determination’ or ‘estimate only’;
if you receive a cheque in reply to a pre-determination, do not cash the cheque and immediately advise the insurance company about the mistake.
IMPORTANT NOTE: Claims cannot be submitted until after a service has been completed. The following are examples of how to submit a Pre-d and a claim for the same treatment plan.
2. Addition to a partial:
How to submit a Pre-d for an addition to a partial denture: EXAMPLE: Addition to a partial mandibular, cast mesh retention welded by a commercial lab. Two teeth and one wrought clasp added in your clinic. Upper and lower impressions taken.
Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
No Date 46320 Partial Mandibular-addition of tooth or clasp
110.00 67.00 177.00
No Date 71311 Opposing Model - impression 47.00 29.00 76.00 No Date 71313 New tooth (each) 22.00 22.00 No Date 72031 Mandibular cash mesh +L +L No Date 71010 Clasp - wrought 45.00 45.00
Total Fee Claimed 320.00+L
How to submit the claim for the same treatment plan:
Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
01/01/2017 46320 Partial Mandibular-addition of tooth or clasp
110.00 67.00 177.00
01/02/2017 71311 Opposing Model - impression 47.00 29.00 76.00 01/02/2017 71313 New tooth (each) 22.00 22.00 01/02/2017 72031 Mandibular cash mesh 67.00 67.00 01/02/2017 71010 Clasp - wrought 45.00 45.00
Total Fee Claimed 387.00
Please note:
Fees are inclusive of an addition of one tooth or an addition of one clasp (if additional teeth and/or clasps are required utilize appropriate 70,000 series codes) The cost for the cast mesh from the commercial lab was 65.00. That fee is added with your Lab Fee (if
applicable) and placed under the Lab Fee when submitting your claim.
The date of service is now placed on the claim.
For repairs, record on the patient’s chart the type of repair and the additional materials used. In the repair example given above (example #1), the chart might read, ‘repair – with impression, model and two teeth.
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C. SUBMITTING ESTIMATES AND CLAIMS (cont’d)
3. Code 71006: Complete Mandibular and Cast Partial Maxillary Dentures
(Existing Format)
How to submit a Pre-d for a complete mandibular and cast maxillary partial: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
No Date 31320 Complete Mandibular-standard 709.00 425.00 1134.00
No Date 41114 Partial Max.-free end-standard 673.00 +L 673.00+L
Total Fee Claimed 1807.00+L
How to submit the claim for the same treatment: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
01/02/2017 31320 Complete Mandibular-standard 709.00 425.00 1134.00
01/02/2017 41114 Partial Max.-free end-standard 673.00 484.00 1157.00
Total Fee Claimed 2291.00
Please note:
The cost of the casting in this example is $150.00. That fee is added with your Lab Fee and placed under the Lab Fee when submitting your claim.
The date of service is now placed on the claim.
OR
Complete Mandibular and Cast Partial Maxillary Dentures (New option)
How to submit a Pre-d for a complete mandibular and cast maxillary partial:
Date Service
Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
No Date 31320 Complete Mandibular-standard 709.00 425.00 1134.00
No Date 41114 Partial Max.-free end-standard 673.00 325.00 1007.00
No Date 71006 Maxillary Casting 150.00 150.00
Total Fee Claimed 2291.00
How to submit the claim for the same treatment: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
01/02/2017 31320 Complete Mandibular-standard 709.00 425.00 1134.00
01/02/2017 41114 Partial Max.-free end-standard 673.00 334.00 1007.00
01/02/2017 71006 Maxillary Casting 150.00 150.00
Total Fee Claimed 2291.00
Please note:
This code is to be used when including a Maxillary Casting to be fabricated by a commercial lab. Ensure you place the cost of the Maxillary Casting under code 71006 and not under code 98888. This format only applies to a Maxillary Partial Denture.
The date of service is now placed on the claim.
Page 40
C. SUBMITTING ESTIMATES AND CLAIMS (cont’d) 4. Code 71007: Complete Maxillary and Cast Partial Mandibular Dentures
(Existing Format)
How to submit a Pre-d for a complete maxillary and cast mandibular partial: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
No Date 31310 Complete Maxillary-standard 572.00 341.00 913.00
No Date 41124 Partial Mand.-free end-standard 703.00 +L 703.00+L
Total Fee Claimed 1616.00+L
How to submit the claim for the same treatment: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
01/02/2017 31310 Complete Maxillary-standard 572.00 341.00 913.00
01/02/2017 41124 Partial Mand.-free end-standard 703.00 503.00 1206.00
Total Fee Claimed 2119.00
Please note:
The cost of the castings in this example is $150.00 each. That fee is added with your Lab Fee and placed under the Lab Fee when submitting your claim.
The date of service is now placed on the claim.
OR
Complete Maxillary and Cast Partial Mandibular Dentures (New option)
How to submit a Pre-d for a complete maxillary and cast mandibular partial: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
No Date 31310 Complete Maxillary-standard 572.00 341.00 913.00
No Date 41124 Partial Mand.-free end-standard 703.00 353.00 1056.00
No Date 71007 Mandibular Casting 150.00 150.00
Total Fee Claimed 2119.00
How to submit the claim for the same treatment: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
01/02/2017 31310 Complete Maxillary-standard 572.00 341.00 913.00
01/02/2017 41124 Partial Mand.-free end-standard 703.00 353.00 1056.00
01/02/2017 71007 Mandibular Casting 150.00 150.00
Total Fee Claimed 2119.00
Please note:
This code is to be used when including a Mandibular Casting to be fabricated by a commercial lab. Ensure you place the cost of the Mandibular Casting under code 71007 and not under code 98888. This format only applies to a Mandibular Partial Denture.
The date of service is now placed on the claim.
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5. Complete Maxillary and Mandibular Dentures
How to submit Pre-d for a new complete maxillary and complete mandibular: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
No Date 31310 Complete Maxillary-standard 572.00 341.00 913.00
No Date 31320 Complete Mandibular-standard 709.00 425.00 1134.00
Total Fee Claimed 2047.00
How to submit the claim for the same treatment: Date
Service Completed
Procedure Code
Description of Service Prof Fee Lab Fee Total Charges
01/02/2017 31310 Complete Maxillary-standard 572.00 341.00 913.00
01/02/2017 31320 Complete Mandibular-standard 709.00 425.00 1134.00
Total Fee Claimed 2047.00
Please note:
When submitting a claim for a procedure where there is a Lab Fee, it is important to keep good records.
You must be able to verify the Lab Fees should an insurance company make inquiries.
Keep the invoices from the commercial lab for all Lab Fees.
If you have further questions or concerns please call the DAO office or visit the DAO website or email to: [email protected] .