FLUORIDE VARNISH:

The purpose of applying topical fluoride to the exterior of teeth is to retard, arrest, and reverse the caries (decay) process. The fluoride benefit in the ABCDE Program is the application of up to three fluoride varnishes per year in the medical office. These applications are in concert with fluoride varnish applications provided at the dental office.

OMNII Oral Pharmaceuticals introduced CavityShield™, the first 5% NaF fluoride varnish in unit-dosed packaging. The company offers their varnish in two dosage sizes of .25 ml and .40 ml. The sizes are based on a safe amount to treat patients with primary dentition (.25 ml) and those with mixed dentition (.40 ml). The doses are provided in a convenient, asepsis friendly, disposable “lollipop” package that includes a bend-a-brush applicator. Sizes are differentiated by brush handle color for easy and safe dosage identification. Also, directions for care after treatment with CavityShield™ Fluoride Varnish are provided for parents.

To order CavityShield™ fluoride varnish, please contact Klint Croucher from Omnii Oral Pharmaceuticals, 1-800-445-3386-Voice Mail Ext. 370; Fax: (800) 476-7677; kcroucher@omniipharma.com

Fluoride Varnish Applications
Fee Schedule

Use the following procedure code to bill MAA for fluoride varnish applications for children under 20 years of age.

Procedure Code D1203

Diagnosis Code V20.2

Description Application of fluoride varnish. Allowed 3 times
in a 12 month period.

Maximum Allowable $13.37