Keep Your Patient's Smile Healthy with Fluoride Varnish
Date: 02/03/22
Tooth decay is the most common preventable childhood disease. As providers, you are the first line of defense against illness and disease for our children. That means playing a role in keeping their smiles big and healthy.
More and more providers nationwide are applying fluoride varnish during routine well visits. From a very early age, applying fluoride varnish provides the most effective protection against tooth decay for children. Fluoride varnish is a gel substance that is applied directly to the teeth. It takes less than two minutes to apply and dries almost instantly.
How to qualify for reimbursement:
Medicaid reimburses providers each time fluoride varnish is applied. Eligible patients are six months to five years old. To be reimbursed, the varnish must be applied as part of a routine well visit. Reimbursement is limited to once every six months per patient. Patients must be between the ages of 6 months and 5 years. Providers eligible for reimbursement for this service include physicians, nurse practitioners, and physician assistants.
Fluoride Varnish Application Reimbursement Codes:
- CPT Code: 99188 (Application of topical fluoride varnish)
- Note: CPT Code 99188 is only reimbursable when performed on the same date of service as an office visit or preventive screening visit and should be billed simultaneously with the visit.
- ICDM-10 Code: Z41.8 (Need for fluoride varnish application)
- CDT Code: D1206 (Professionally applied fluoride varnish)
Who Can Apply Fluoride Varnish?
- Pediatricians
- Nurse Practitioners
- Physician Assistants
- Registered Nurses
- Licensed Practical Nurses
- Certified Medical Assistants
*Physicians must maintain documentation in the employee records indicating competency for staff involved in the application of fluoride varnish.
Important: To apply fluoride varnish and be reimbursed, you must be Smiles for Life certified. It only takes an hour to complete the free lifetime certification online.
Get Smiles for Life Certified:
- Visit the Smiles for Life website: www.smilesforlifeoralhealth.org.
- Review the training module: Course No. 6: Caries Risk assessment, Fluoride Varnish & Counseling.
- Complete and pass the exam.
- Maintain a copy of the successfully completed post assessment certificate in employee records.
To learn more about fluoride varnish visit wellaheadla.com/prevention/oral-health/fluoride-varnish/.