The 837 Dental Implementation Guide does not offer an element (field) to report the Emergency Service Indicator. DOH recognizes that without an indicator, recipients whose eligibility is limited to only emergency services will not be able to get their claims paid. For this reason, DOH has provided a list of procedure codes to be used when submitting emergency services claims for recipients that are eligible for emergency services only.

EMERGENCY SERVICES DENTAL PROCEDURES  

D0160 Detailed and extensive oral evaluation - problem focused

D0220 Periapical; first film

D0230 Periapical; each additional film

D0330 Panoramic film

D2920 Recement crown

D2931 Prefabricated stainless steel crown; permanent tooth

D2932 Prefabricated resin crown

D6930 Recement fixed partial denture

D7140 Extraction, erupted tooth or exposed root

D7250 Surgical removal of roots

D7510 Incision and drainage of abscess; intraoral soft tissue

D7520 Incision and drainage of abscess; extraoral soft tissue

D7530 Removal of foreign body

D7610 Maxilla [fracture]; open reduction

D7620 Maxilla [fracture]; closed reduction

D7630 Mandible [fracture]; open reduction

D7640 Mandible [fracture]; closed reduction

D7820 Closed reduction of dislocation

D7910 Suture of recent small wound up to 5 cm

D7911 Complicated suture; up to 5 cm

D7912 Complicated suture; greater than 5 cm

D7999 Limited to Surgical Extractions; when codes D7210, D7220, D7230, D7240 and D7241 would be used *** D7999 is only to be used for paper claims, and a report needs to accompany the claim(s).

D9110 Palliative (emergency) treatment of dental pain - minor proc.

D9220 Deep sedation - first 30 minutes

D9221 Deep sedation - each additional 15 minutes

D9241 IV conscious sedation - first 30 minutes

D9242 IV conscious sedation - each additional 15 minutes