Dr. Scollard expresses a variety of concerns in his comments. His letter and Dr. Christensen’s response both recognize the evolution in dental procedures and materials, their influence on treatment planning and their influence on fees.
Every year I see patients collectively spend thousands of dollars because they were not offered the judicious use of cast gold in requisite circumstances.
Dr. Scollard also correctly points out that the number of crown procedure codes in the Code on Dental Procedures and Nomenclature (Code) does not equal the variety of porcelain-fused-to-metal (PFM) crowns that are available today.
The Code in its current form enables reporting of PFM crowns using the Classification of Metals established by the American Dental Association Council on Scientific Affairs: high noble, noble and predominantly base.
This classification is based on the relative percentage of precious metal in the crown’s foundation. The Code does not address the ratio of porcelain to metal in a crown, which appears to be Dr. Scollard’s concern.
The Code is a living document that can change, and has changed, to reflect evolution in techniques and materials. The addition of a procedure code for titanium crowns effective Jan. 1, 2005,1 is one example of such change. The process for requesting changes to the Code is open to any dentist or interested party, and Dr. Scollard is encouraged to take advantage of the process.
Information about the Code’s maintenance process is available online at "www.ada.org/goto/dentalcode". Additional information is available from the ADA Council on Dental Benefit Programs (ADA member toll-free number, Ext. 2753; direct dial 1-312-440-2753).
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