How to interpret Canadian Dental Codes

How to interpret Canadian Dental Codes

The Canadian Dental Association has a list of commonly used codes in Canada for dental procedures. While specific provincial dental associations have certain codes that are unique to their own province, the majority of provinces use the same5 digit  dental codes for routine procedures. The goal of this article is to help you to familiarize yourself with the different code subcategories in order to help you better navigate through them.

 

The Canadian dental codes are broken into different categories based on procedure.

 

Diagnostic Services (Codes ranging from 00001 09999),which includes services such as exams, radiographs, laboratory tests, consultations, and patient records (including photographs and dental casts/models)

 

Preventive Services (codes ranging from 10000-19999),which includes services such as cleanings/scaling, polishing, fluoride, nutritional counselling, oral appliances (used for bruxism/teeth grinding, sleep apnea, or temporomandibular joint disorders for example), space maintainers,  and the grinding or recontouring of existing restorations or teeth.

 

Restorative Services (codes ranging from 20000-29999),which includes services like restorations/filings, inlays/onlays, crowns (including removals and recementation) and different adjuncts used in fillings like pins, posts, cores

 

Endodontic Services (codes ranging from 30000-39999),which includes services like pulpectomies, root canals, apical surgery or bleaching of root canal treated teeth.  Codes in this range relate to procedures involving the tooth pulp/nerve.

 

Periodontal Services (codes ranging from 40000-49999),involves procedures and services such root planning, periosteal splints, the management of oral disorders and pathologies, gum surgeries like grafts and tissue regeneration, and the application of chemotherapeutic and antimicrobial agents (ie. Peridex/chlorhexidine, arestin). Codes in this range relate to procedures that involve the gums or the periodontium.

 

Removable Prosthetics (codes ranging from 50000-59999),involves procedures and services related to removable dentures. This includes procedure codes that relate to removable denture insertion, adjustment, repair, relining etc.

 

Fixed Prosthodontic Services (codes ranging from 60000-69999), involves procedures and services related to dental bridge/fixed partial dentures or resin bonded (Maryland bridge). A “retainer” the natural tooth that is attached to the false tooth also referred to as the “pontic”.

 

Oral and Maxillofacial Surgery (codes ranging from 70000-79999),involves  procedures and services like extractions, removal and recontouring of bone (alveoloplasty) and gums (gingivectomy/gingivoplasty), biopsies, dental implant placement, and jaw/facial surgeries

 

Orthodontic Services (codes ranging from 80000-89999),involves services related to appliances that move the teeth. This includes fixed bracket-wires (braces) and removable clear aligners (ie. Invisialign), space regaining appliances, palatal expanders etc.

 

Adjunctive General Services (codes ranging from 90000-99999), includes procedures related to sedation (general anesthesia, nitrous, oral sedation), management of extraordinary patients, consultations with other professionals,  court appearances and related documents, bleaching/whitening, administration of drugs like botox and prescriptions, and tobacco cessation services.

 

General Notes

 

For many diagnostic or preventive procedures like scaling  or consultations, the final digit in the code denotes the number of units of time, where 15 mins= 1 unit. For example, the scaling code is 1111# and the # denotes unit of time (15mins). Therefore code 11111 would be a cleaning that lasts 15 mins; 11112 would be a cleaning that lasts 30 mins etc. A nine as the last digit typically denotes every additional unit.

 

For xrays  and photographs, the final digit in the code denotes the number of images. For example, the code for a periapical radiograph is 0211#. The code 02112 would mean that 2 periapical xrays were taken.

 

For restorative services, the final digit typically denotes the size of filling. For example the code 2310# is for a white filling on an anterior permanent tooth and # is the number of surfaces. There is a maximum of 5 surfaces on a tooth and they are denoted as mesial, distal, occlusal, buccal and lingual.  Therefore the code 23102 would be a white filling on a permanent anterior tooth that is two surfaces.

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51 thoughts on “How to interpret Canadian Dental Codes

  1. My insurer SunLife uses the Canadian dental codes. I had dental work done in the Philippines and they did not know the code for cephalomeric X-rays. The insurer did not know the code either. Can you help?

  2. what are the canadian dental codes for-
    1.. implant (do we need to split to labour and material costs),
    2. implant crown
    3. implant bridge pontic?

    1. Hi Rosa,
      We have a specific list of codes related to dental implants in our app “Dental Code Lookup”.
      However I believe the codes that you are looking for are
      1.Generally this code is used 79931 Surgical Installation of Implant with Cover Screw – per Implant (labor and expense should be added)
      2. Implant crown 27305 (ceramic implant supported crown), 26102 (implant abutment- component that attaches the implant to crown)
      3.62501 Porcelain/Ceramic/Polymer Glass Fused to Metal (PFM) Pontic
      62502 Porcelain/Ceramic/Polymer Glass, Aluminous Pontic

  3. I had a Surgical Exam done to see what needed to be done to remove a broken molar. My insurer, Sunlife needs the code as well.
    They used a procedure code on the invoice of 0601 but I think it is wrong and I am being asked for international tooth code (first molar behind the eye tooth on the top left side was broken).

    Any help would be appreciated!

    1. Hi Curtis,
      Was the exam performed in Canada? I am not seeing a code of 0601 in the list of Canadian Dental codes

    1. Hi Caroline,
      A complete list of all codes is on our mobile app Dental Code Lookup. Most of the codes are common to all provinces, however there are certain codes that are specific to provinces. Was there any code in particular that you were looking for?

  4. I had work completed in Mexico and my insurer SunLife uses the Canadian Dental codes. I am trying to find a complete list of coding for Saskatchewan but the only complete codes I can find is for Alberta. Can I use Alberta’s coding? Are you able to send me a copy of the codes?
    On my dental form the codes that I looked up (Alberta codes) are the same codes that the dentist office in Mexico use, therefore I am unsure why SunLife needs more of an explanation.
    I had a surgical removal of an implant on tooth 22 and cannot find a code for that either.
    Thanks
    Jeannette Rachul

    1. Did they remove the implant or just the crown?
      Here are a couple of codes for you
      29311 Removal of implant-supported crowns, one unit of time
      79961 Removal of implant, Per implant, Uncomplicated
      79962 Removal of implant, Per implant, Complicated

  5. I just sent an email to your address. Here is the content
    Good morning

    I saw an earlier reply where you provided a code. I had the following done in Mexico and need Canadian dental codes for the following:

    Consultation (included xrays) ($35)

    Composite fillings ( 8 in all) in 8 separate teeth ($282)

    Crown Build up ($70)

    Zirconia monolithic crown ($385)

    Any assistance you could provide would be very helpful.

    Sincerely
    Elaine Hughston

    1. Hi Elaine,
      Sorry for the delay in response. We have been closed due to COVID-19.

      Consultation- often in Canada we bill this either as a specific exam (01204)- exam for specific area, or emergency exam (01205) or complete exam (01103)- exam of full mouth
      Filing codes vary based on size of filling and tooth- do you have the exact tooth number and surfaces (this is often notated as something that looks like 14MOD etc
      Crown build up code 23601
      Zirconia crown (27201)

      Let me know if you have additional questions

  6. My insurer SunLife uses Canadian dental codes. I had dental work done in Iran and they did not know the code for repairing a chipped tooth. The insurer did not know the code either. Can you help?

    1. Hi Shayaan, unfortunately we do not have the PDF file for the codes as there are very many codes. By downloading the app Dental Code Lookup, you will have access to complete list of codes. Hope this helps. Thanks

  7. Hello
    I had the following done in Switzerland for a cast metal partial prosthesis/dentures supported by natural teeth:
    -Planning
    -Print DH (gypsum cast)
    -Register with template
    -Colour selection
    -Centric register
    -Front tooth adjustment
    -cast metal prosthesis (partial)
    -Laboratory cost for above prosthesis
    -Prosthesis post adjustments (2x)
    The terms used here may not be accurate as the bill is in German.
    Could you please give me the Canadian codes in order that I can inform Canada Life assurance company.
    Thank you for your help
    Juerg

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    1. Thank you for your question! Billing code will depend on your treatment modality- fixed, removable etc.
      If you download our mobile app “Dental Code Lookup” all of the codes that you are looking for are under the “Ortho” tab

  16. Hello, I live in Ontario. Please let me know what are the codes for child under 16 braces and invisalign ?

    1. Hi Arshad, thanks for your question. Initial pre determinations in Ontario are generally sent using the code 80000- this is for the discovery of benefits.
      All ortho codes are found on our mobile app “Dental Code Lookup”. We have created a nice category called “Ortho” that has all of the billing codes. Hope this helps. Please reach out if you have any other questions.

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    1. Hi JD, all extraction codes are in our app Dental Code Lookup. The codes vary on difficulty of the extraction- for example if the teeth are erupted vs covered in bone.

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