How To Use CPT Code 99188

CPT 99188 describes the application of topical fluoride varnish by a physician or other qualified health care professional. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 99188?

CPT 99188 can be used to describe the application of a fluoride adhesive over the tooth surface by a physician or other qualified health care professional. This procedure is performed to prevent tooth decay, provide remineralization, or treat hypersensitivity. The fluoride varnish is applied using a brush or an applicator, and it adheres to the tooth surface. The varnish is left on the teeth overnight, and the patient is advised not to brush their teeth for the rest of the day.

2. Official Description

The official description of CPT code 99188 is: ‘Application of topical fluoride varnish by a physician or other qualified health care professional.’

3. Procedure

1. The teeth are cleaned and debris is removed.
2. A small amount of fluoride varnish is applied to the tooth surface.
3. The varnish is brushed or applied using an applicator to ensure it adheres to the teeth.
4. The varnish is left on the teeth overnight.
5. The patient is advised not to brush their teeth for the rest of the day.

4. Qualifying circumstances

CPT 99188 is performed by a physician or other qualified health care professional. It is used to prevent tooth decay, provide remineralization, or treat hypersensitivity. The procedure involves the application of a fluoride adhesive over the tooth surface. There are no specific qualifying circumstances mentioned for this code.

5. When to use CPT code 99188

CPT code 99188 should be used when a physician or other qualified health care professional applies topical fluoride varnish to the tooth surface. This code is appropriate for procedures aimed at preventing tooth decay, providing remineralization, or treating hypersensitivity. It should not be used for other dental procedures or treatments.

6. Documentation requirements

To support a claim for CPT 99188, the health care professional must document the following information:

• Patient’s diagnosis or reason for the procedure
• Date of the procedure
• Details of the fluoride varnish applied
• Instructions given to the patient regarding post-procedure care
• Signature of the physician or qualified health care professional performing the procedure

7. Billing guidelines

When billing for CPT 99188, ensure that the procedure is performed by a physician or other qualified health care professional. Follow the specific guidelines provided by the payer for proper documentation and coding. It is important to note that CPT 99188 should not be reported with other codes unless specified by the payer.

8. Historical information

CPT 99188 was added to the Current Procedural Terminology system on January 1, 2015. There have been no updates or changes to the code since its addition.

9. Examples

1. A dentist applies fluoride varnish to a child’s teeth to prevent tooth decay.
2. A dental hygienist applies fluoride varnish to a patient’s teeth to provide remineralization.
3. A pediatrician applies fluoride varnish to a toddler’s teeth to treat hypersensitivity.
4. An oral surgeon applies fluoride varnish to a patient’s teeth after a dental procedure to prevent tooth decay.
5. A family physician applies fluoride varnish to an adult patient’s teeth to provide remineralization.
6. A nurse practitioner applies fluoride varnish to an elderly patient’s teeth to treat hypersensitivity.
7. A dentist applies fluoride varnish to a teenager’s teeth to prevent tooth decay.
8. A dental hygienist applies fluoride varnish to a pregnant patient’s teeth to provide remineralization.
9. A pediatrician applies fluoride varnish to a young child’s teeth to treat hypersensitivity.
10. An oral surgeon applies fluoride varnish to a patient’s teeth before orthodontic treatment to prevent tooth decay.