Blue Cross Blue Shield FEP Dental
Class B Intermediate

D3110 Pulp cap - direct (excluding final restoration)

D3120 Pulp cap - indirect (excluding final restoration)

D3220 Therapeutic pulpotomy (excluding final restoration) - removal of pulp coronal to the dentinocemental junction and application of medicament - Primary teeth only, 1 per lifetime

D3221 Pulpal debridement, primary and permanent teeth

D3222 Partial pulpotomy for apexogenesis – permanent tooth with incomplete root development - Limited to 1 per lifetime

D3230 Pulpal therapy (resorbable filling) – anterior, primary tooth (excluding final restoration) - Limited to 1 per lifetime

D3240 Pulpal therapy (resorbable filling) – posterior, primary tooth (excluding final restoration) - Limited to 1 per lifetime

D3355 Pulpal regeneration - initial visit

D3356 Pulpal regeneration - interim medication replacement

D3357 Pulpal regeneration - completion of treatment