New Jersey Administrative Code
Title 10 - HUMAN SERVICES
Chapter 56 - MANUAL FOR DENTAL SERVICES
Subchapter 3 - HEALTHCARE COMMON PROCEDURE CODING SYSTEM (HCPCS)
Section 10:56-3.5 - D3000-D3999 ENDODONTICS

Universal Citation: NJ Admin Code 10:56-3.5

Current through Register Vol. 56, No. 18, September 16, 2024

(a) Therapeutic Pulpotomy:

Maximum Fee
HCPCSAllowance
INDCodeModProcedure DescriptionS$NS
D3220Therapeutic Pulpotomy (Excluding28.0026.00
Final Restoration)--removal of
pulp coronal to the
Dentinocemental junction and
application of medicament
D3221Gross pulpal debridement, Primary28.0026.00
and Permanent teeth
D3230Pulpal therapy (resorbable74.0067.50
filling)--Anterior, Primary Tooth
(excluding final restoration)
D3240Pulpal therapy (resorbable95.0086.50
filling)--Posterior, Primary Tooth
(excluding final restoration)

(b) Root Canal Therapy (including treatment plan, clinical procedures, and follow-up care):

1. For emergency endodontic procedures, use code D3220.

D3310Anterior (excluding final148.00135.00
restoration)

NOTE: Code to be used for incisors and cuspids (permanent).

D3320Bicuspid (excluding final190.00173.00
restoration)

NOTE: Code to be used for premolars and all primary teeth without permanent successors.

D3330Molar (excluding final restoration)247.00225.00

NOTE: Code to be used for molars (permanent).

D3346Retreatment of previous root canal148.00135.00
therapy--anterior
D3347Retreatment of previous root canal190.00173.00
therapy--bicuspid
D3348Retreatment of previous root canal247.00225.00
therapy--molar
D3351Apexification/ recalcification--In31.0027.00
itial visit (apical
closure/calcific repair of
perforations, root resorption,
etc.)

NOTE 1: Treatment may extend over a period of six to 18 months.

NOTE 2: Maximum--two visits.

(c) Apicoectomy/periradicular Services:

1. Periradicular surgery is a term used to describe surgery to the root surface, for example, apicoectomy, repair of a root perforation or resorptive defect, exploratory curettage to look for root fractures, removal of extruded filling materials or instruments, removal of broken root fragments, sealing of accessory canals, etc. This does not include retrograde filling material placement.

D3410Apicoectomy/periradicular79.0072.00
surgery--anterior

(d) Apicoectomy performed in conjunction with endodontic procedure:

1. Single stage nerve extirpation and canal filling. Services provided at same visit.

D3421Apicoectomy/periradicular79.0072.00
surgery--Bicuspid (first root)
D3425Apicoectomy/periradicular79.0072.00
surgery--Molar (first root)
D3426Apicoectomy/periradicular44.0036.00
surgery--(Each additional root)
D3430Retrograde Filling--Per Root9.007.50

NOTE 1: Reimbursable only in addition to apicoectomy.

NOTE 2: Maximum per tooth--three roots.

D3450Root Amputation--Per Root55.0048.00

NOTE 1: Surgical resection of entire root(s).

NOTE 2: Maximum two roots.

(e) Other endodontic procedures:

D3920Hemisection (Including Any Root55.0048.00
Removal), Not Including Root Canal
Therapy
D3950Canal Preparation and Fitting of16.0014.00
Preformed Dowel or Post

NOTE: Should not be in conjunction with D2952, D2954, by the same practitioner.

D395022Canal Preparation and Fitting of23.0020.00
Preformed Dowel or Post

NOTE 1: Can be used when the final restoration is an amalgam or composite resin.

NOTE 2: With cementation.

d*D3999Unspecified Endodontic Procedure,BRBR
By Report

Disclaimer: These regulations may not be the most recent version. New Jersey may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.