Benefit limitation for D3120 (Indirect Pulp Cap)
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This notice governs reimbursement limitations effective April 1, 2020 for procedure code D3120 (Indirect Pulp Cap) within the DentaQuest Dental network; D3120 will not be reimbursed when submitted with certain other procedure codes for the same tooth on the same date of service.
Effective April 1, 2020 D3120 - Indirect Pulp Cap will not be reimbursed when submitted with the following procedure codes for the same Tooth, same Date of Service.
Coverage Criteria
D3120 billing prohibition
Coverage restriction effective April 1, 2020:
See the Office Reference Manual (ORM) for the specific list of conflicting codes and benefit details.
Coding and Billing Details
| D3120 | Indirect Pulp Cap |
Provider Actions / Billing Impacts
Restriction on D3120 reimbursement
Effective April 1, 2020 D3120 (Indirect Pulp Cap) will not be reimbursed when submitted with specified other procedure codes for the same tooth on the same date of service; consult the Office Reference Manual for the specific conflicting codes and benefit details.
- Applies when D3120 is billed for the same tooth and same date of service as one of the specified conflicting procedures
- See the Office Reference Manual (ORM) for the full list of conflicting procedure codes and benefit details
Definitions
OpenPayer is powered by Trek Health's payer performance platform. Trek continuously ingests, validates, and normalizes Transparency in Coverage data alongside payer policies and other commercial payer data to create a structured payer intelligence foundation. OpenPayer uses this foundation to deliver personalized search results, dynamically generated policy pages, and tailored policy monitoring based on each user's payers, specialties, billing codes, and areas of interest. The same intelligence powers broader payer performance workflows, including reimbursement benchmarking, contract evaluation, payer negotiations, and financial decision-making.