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29.2.18.9 Dental Screening and Intermediate Oral Evaluation with Fluoride Varnish Application in the Medical Home
The physician or advanced practice nurse (APN) must refer clients to a dental home for dental checkups beginning at 6 months of age and every 6 months thereafter. Clients or their caretakers may self-refer for dental services at any age.
Dental Screening
Dental screening is a part of the preventive care medical checkup and must include:
• Inspection of teeth for signs of early childhood caries, and other caries
•Inspection of the oral soft tissues for abnormalities
•Anticipatory guidance to include:
•The need for thorough daily oral hygiene practices
•Potential gingival manifestations for clients with diabetes and clients under long-term medications therapy
Intermediate Oral Evaluation with Fluoride Varnish Application
An intermediate oral evaluation with fluoride varnish application (procedure code 99429) is a benefit for clients 6 months of age through 35 months of age. Procedure code 99429 must be submitted with modifier U5 and diagnosis V202.
The intermediate oral evaluation with fluoride varnish application must be billed on the same date of service as a medical checkup or an exception to the periodicity visit (procedure codes 99381, 99382, 99391, or 99392) and is limited to 6 services per lifetime by any provider.
An intermediate oral evaluation with fluoride varnish application is limited to preventive care medical checkup providers who have completed the required benefit education and who are certified by the DSHS Oral Health Program to perform an intermediate oral evaluation with fluoride varnish application. The intermediate oral evaluation with fluoride varnish application add-on includes the following component:
•Intermediate oral evaluation
•Fluoride varnish application
•Dental anticipatory dental guidance to include:
•The need for thorough daily oral hygiene practices
•Education in potential gingival manifestations for clients with diabetes and clients under long-term medication therapy
•Diet, nutrition, and food choices
•Fluoride needs
•Injury prevention
•Antimicrobials, medications, and oral health
•Referral to a dentist to establish a dental home
•Additional dental anticipatory guidance if the client has no erupted teeth
Note: The physician or APN must complete the intermediate oral evaluation but can delegate all other components.
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