CDT Coding Changes for Topical Application of Fluoride

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Effective for dates of service on or after January 1, 2013, the following procedure codes will no longer be accepted by the South Carolina Department of Health and Human Services (SCDHHS).

  • D1203 – Topical application of fluoride – child
  • D1204 – Topical application of fluoride – adult

The procedure code listed below will be added by SCDHHS effective for dates of service on or after January 1, 2013.  The new code replaces the two deleted codes above and will be reimbursed at the same rate of $15.89.  Frequency limitations are also the same as the deleted codes; one per six(6) months per patient.

  • D1208 – Topical application of fluoride

If you have any questions or concerns regarding this bulletin, please contact the Dentaquest Provider Service Center at 888-307-6553.  Thank you for your continued support of the South Carolina Medicaid program.

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