Child Dental Scheme T&C’s – Part 5 – Root Canal Treatments (Endodontics)

Treatment of the root canals may involve initial, partial treatment, temporary or permanent treatments. There is a limit on the amount of total treatment that can be done under the child dental scheme over two years. I always think prevention is better than cure; however trauma may cause a nerve to die.

• 88411 Direct pulp capping
  A dressing is placed on a very small exposure of the nerve. If there has been no pain then this treatment has about a 40% chance of working.
• 88412 Incomplete endodontic therapy (tooth not suitable for further treatment)
  Limit of one (1) per tooth.
• 88414 Pulpotomy
  A benefit does not apply if a benefit has been paid for item 88421 on the same tooth on the same day.
• 88415 Complete chemo-mechanical preparation of root canal – one canal
  Limit of one (1) per tooth per day.
• 88416 Complete chemo-mechanical preparation of root canal – each additional canal
  Limit of two (2) per tooth per day. Bit of a problem here! Some teeth have more than 3 canals especially the upper first adult molars.
• 88417 Root canal obturation – one canal
  Limit of one (1) per tooth per day.
• 88418 Root canal obturation – each additional canal
  Limit of two (2) per tooth per day. Bit of a problem here! Some teeth have more than 3 canals especially the upper first adult molars.
• 88419 Extirpation of pulp or debridement of root canal(s) – emergency or palliative
  This is the relief of pain treatment. Further work needs to be done to clean the root canal thoroughly, and take accurate measurements so to clean the canal near the end of the root.

Note: A benefit does not apply if a benefit has been paid for an extraction, metallic or adhesive restoration service or items 88411, 88415, 88416, 88417, 88421, 88455, 88458, on the same tooth on the same day.

• 88421 Resorbable root canal filling – primary tooth
  Limit of one (1) per tooth. A benefit does not apply if a benefit has been paid for item 88414 on the same tooth on the same day.

Note: Items 88411-88421 – A benefit does not apply if the service is provided within 3 months of a service under item 88458. A benefit does not apply if a benefit has been paid under item 88412 on the same tooth.

• 88455 Additional visit for irrigation and/or dressing of the root canal system – per tooth
  A benefit does not apply if a benefit has been paid for item 88414, 88415, 88416, 88417, 88418 or 88421 on the same tooth on the same day. A benefit only applies if the service is provided within 3 months of a service under item 88415 or 88416.
• 88458 Interim therapeutic root filling – per tooth
  This treatment is sometimes carried out to allow healing to occur after for example trauma to a developing tooth. The nerve may have died but the root tip is still forming. A special dressing is placed to provide ingredients to allow the developing tissue to complete the root formation and provide a stronger root for life! The dressing may remain for months. Limit of three (3) per 12 month period.

Note: Items 88455 & 88458 – a benefit does not apply if a benefit has been paid under item 88412 on the same tooth.

Next week: Child Dental Scheme T & C ‘s – Part 6 – Restorative Services