TMPPM 2011 > Children's Services Handbook > THSteps Medical > Services/Benefits, Limitations, and Prior Authorization > Screening Components With Additional Requirements > Dental Screening and Intermediate Oral Evaluation with Fluoride Varnish Application in the Medical Home

5.3.2.8.2 Intermediate Oral Evaluation with Fluoride Varnish Application

An intermediate oral evaluation with fluoride varnish application (procedure code 99429) is a benefit for clients who are 6 through 35 months of age.

The intermediate oral evaluation with fluoride varnish application must be billed on the same date of service as a medical checkup visit and is limited to six services per lifetime by any provider. Procedure code 99429 must be billed with modifier U5 and diagnosis code V202.

An intermediate oral evaluation with fluoride varnish application is limited to THSteps medical checkup providers who have completed the required benefit education and are certified by DSHS Oral Health Program to perform an intermediate oral evaluation with application of fluoride varnish. Training for certification is available as a free continuing education course on the THSteps website at www.txhealthsteps.com. The intermediate oral evaluation with fluoride varnish application add-on includes the following components:

•Intermediate oral evaluation

•Fluoride varnish application

•Dental anticipatory 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

•THSteps eligibility qualifies the client for dental services

•Diet, nutrition, and food choices

•Fluoride needs

•Injury prevention

•Antimicrobials, medications, and oral health

If the client has no erupted teeth, additional dental anticipatory guidance is expected.

Note: The physician must complete the intermediate oral evaluation but can delegate all other components.