Bacteriologic Studies, Culture

Policy No: 04
Originally Created: 03/01/1997
Section: Diagnostic Last Reviewed: 01/01/2019
Last Revised: 01/01/2018
Approved: 01/01/2018
Effective: 01/01/2018


Bacteriologic studies for determination of pathologic agents (D0415) May include, but is not limited to tests for susceptibility to periodontal disease.


Procedure is in accordance with generally accepted standards of dental practice.

Non covered service - not necessary for diagnosis or treatment.

Administrative guidelines

Deny when done for educational instruction or when a contract exclusion.

Process to contract benefits. Not covered - necessity not established for diagnosis or treatment.


CDT - D0100-D0999 - see above.


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