As of January 1, 2018, Blue Cross covers an interim caries arresting treatment in certain situations. This treatment is typically with silver diamine fluoride, under CDT code D1354, per tooth.
How is silver diamine fluoride used?
Silver diamine fluoride is appropriate when the patient has a deep, active carious lesion and it will be an extended period of time before they can return for a conventional treatment. This could apply to nursing home patients where transport to the office could be difficult or in school settings where a child has a deep active lesion and regular dental care is not available.
Although highly effective at preventing decay, this medicament stains the carious lesions it is applied to as well as any restorative margins that it touches. Although it’s clear and odorless, it can also stain skin and clothing.
When is silver diamine fluoride not covered?
We will not cover this treatment when:
Both Blue Cross and Blue Cross Blue Shield of Massachusetts and our dentists have always believed in the importance of preventive care. This product, when used properly, is another tool that can be used to keep our members healthy.
As always, thank you for the care you provide to our members.
If you have questions about this topic, call your Dental Network Manager at 1-800-882-1178, option 4.