Occlusal Adjustment

Policy No: 61
Originally Created: 03/01/1997
Section: Adjunctive General Services
Last Reviewed: 01/01/2020
Last Revised: 01/01/2020
Approved: 01/16/2020
Effective: 02/01/2020

This policy applies to all dental providers.


Occlusal adjustment
An occlusal adjustment is the reshaping of the occlusal surface of a tooth or teeth to provide an improved contact between the maxillary and mandibular teeth.

Policy statement

Procedure is non-covered service, policy exclusion.

  • D9951: Occlusal adjustent, limited
  • D9952: Occlusal adjustment, complete

"Positive coronoplasty" is placing restorations to modify occlusion, also a policy exclusion.


American Dental Association, Current Dental Terminology (CDT®)

Policy Cross References



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