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Agmt98 Delta Dental
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Agmt98 Delta Dental
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Last modified
7/5/2005 2:59:37 PM
Creation date
5/20/2005 2:45:37 PM
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Agreement
Contractor Name
Delta Dental
PROJECT NAME
coverage for police officers & sergeants
RMP File Number
304
Date
2/2/1998
Reso Ref
13279
Box
5933
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<br />- ----------------- <br /> <br />------ ------------ <br /> <br />--------- <br /> <br />Complicated suturing (reconstruction requiring delicate handling of <br />tissues and wide underDdning for meticulous closure) <br /> <br />07911. <br />0791.2 <br /> <br />Suture of complex wounds up to scm, by report <br />Suture of complex wounds greater than 5 cm, by report <br /> <br />Other repair procedures <br /> <br />07960 <br /> <br />Frenulectomy (frenectomy or frenotomy) <br />procedure <br />Excision of hyperplastic tissue -- per arch <br />Excision of pericoronal gingiva <br />Sialo1ithotomy <br />Excision of salivary gland, by report <br />Sia1odochoplasty - <br />Closure of salivary fistula <br /> <br />separate <br /> <br />07970 <br />0797l. <br />07980 <br />07981. <br />07982 <br />07983 <br /> <br />09000-09999 -- ADJUNCTIVE GENERAL SERVICES <br /> <br />Unclassified treatment <br /> <br />091.1.0 <br /> <br />Palliative (emergency) treatment of dental pain -- minor <br />procedures <br /> <br />Anesthesia <br /> <br />0921.1. <br />09212 <br />09220 <br />09221. <br /> <br />Regional block anesthesia <br />Trigeminal division block anesthesia <br />General anesthesia -- first 30 minutes <br />General anesthesia -- each additional 1.5 minutes <br /> <br />Professional consultation <br /> <br />093J.0 <br /> <br />Special consultation (specialist only -- separate fee <br />only if patient not treated by consultant) <br /> <br />Professional visits <br /> <br />09430 <br /> <br />Office visit for observation (during regularly scheduled <br />hours) -- no other services performed <br />Office visit -- after regularly scheduled hours <br /> <br />09440 <br /> <br />12 <br /> <br />------ u <br /> <br />-- <br /> <br />-- <br /> <br />--- <br /> <br />--- <br /> <br />---- <br />
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