Prosthodontics – Part 1 – Items 611-659

E.g. Crowns, bridges, and repairs

611-629 – Crowns

Care you may need to be in the health fund for 12 months. Some levels of cover may not rebate this item as it is considered a cosmetic item. There is also a limit for the year. It is important to ask the health fund what is the limit for the year AND when does the year start and finish. Is it the calendar year, the financial year, the date joined, or a date specific for that health fund? This can be important as timing of treatment, if possible, allows the most effective use of your health fund rebates. Some funds have a loyalty bonus that allow for extra rebates. This bonus may have an expiry date, so the timing treatment would be important here as well. The dentist cannot ask the fund on your behalf due to privacy issues. The health fund is a relationship with the patient and NOT the dentist.

It’s important to find out eligibility and rebate amount before starting treatment. It’s advisable to get the person’s name, time of call and call centre location of the health fund operator, so if there is any dispute you can prove who gave you the information. This is important if a decision to proceed with a crown was based on the rebate and eligibility for such treatment. This has forced funds to pay the rebate that was stated either over the phone or at a health fund office.

Unfortunately, you need to do your homework!

Common item numbers used include:

613 – Full crown – non metallic – indirect. An artificial crown made of tooth coloured materials, usually ceramics.

615 – Full crown – veneered – indirect. An artificial crown made with a metal base, then veneered with tooth coloured materials, usually ceramics. It is commonly known as a VMK. This is an abbreviation of the German words “VITA Metal Keramik” for the process of firing the ceramic onto the metal base. It is also known as Porcelain fused to Metal or PFM.

618 – Full crown – metallic – indirect. An artificial crown made of cast metal, usually a gold alloy. They are commonly used in back teeth that are under heavy loads and have limited room. Preparation of the tooth requires less tooth removal and gold have the ability to be strong but have some give to it. This reduces the wear on the opposing teeth. If the biting is heavy sometimes ceramic in crowns may crack.

625 – Post & core – indirect. A post and core (foundation) for the crown which is casted in a laboratory. It is made of various metal alloys. The post is made to fit a prepared root canal after a root canal treatment has been done. The post & core provides retention to the crown to the tooth if there is not enough tooth structure to support the crown.

627 – Preliminary restoration for crown – direct. This is a direct filling of any variety that is used to build up a tooth to support the crown. Pins (575) or posts (597) may be need and are itemised separately.

Provisional crown & bridge, on tooth or implant

This numbers are used usually in an emergency situation where a tooth had broken and a temporary “tooth” needs to be placed. This is before proper preparation of the tooth or implant for the proper “tooth”. It is not used once the proper preparation has been done and a temporary “tooth” is made until the proper one is made.

631 – Provisional crown per tooth

632 – Provisional bridge pontic – per pontic – (false tooth joined to 631 but not sitting on a tooth or implant)

633 – Provisional implant abutment- per abutment (implant “root”) – foundation or core on an implant

634 – Provisional implant restoration – per implant abutment (implant “root”) – temporary crown on the core (633) on an implant

Bridges

642 – Bridge per pontic – direct – per pontic – false tooth joined to a tooth and made in the mouth

643 – Bridge per pontic – indirect – per pontic – false tooth joined to crown (611-618) or to an implant crown (671-673) or to another pontic. Made in a laboratory.

Repairs and other services

Common numbers used include:

651 – Recement crown or indirect veneer

652 – Recement bridge – per tooth holding the bridge

655 – Removal of crown

656 – Removal of bridge

658 – Repair or crown or bridge – indirect – sent to laboratory for repair

659 – Repair or crown or bridge – direct – achieved in the mouth without removing the crown or bridge.

Lots of numbers to remember! Next instalment will be implant item numbers. But let’s have a break from the items numbers for a little while.

Next week: Rebecca’s escape to the country – Cessnock rural placement