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May 2013 CSHCN Services Program Provider Manual

14 Dental : Benefits, Limitations, and Authorization Requirements : Preventive Services : Oral Hygiene Instruction

14.2.4.2 Oral Hygiene Instruction
Procedure code D1330 may be considered for reimbursement for clients who are 1 year of age or older when the services are above and beyond the routine brushing and flossing instructions included in the prophylaxis procedure codes and when additional time and expertise is directed toward the client’s care. Procedure code D1330 is limited to once per year by any provider and is denied when billed on the same day as procedure codes D1110, D1120, D1206, or D1208 by the same provider.
Procedure code D1330 is not reimbursed to orthodontists or oral maxillofacial surgeons. These providers may be reimbursed by the CSHCN Services Program as a dentist or dentistry group provider type by using the appropriate provider identifier when billing claims.

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