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Official Description

Application of topical fluoride varnish by a physician or other qualified health care professional

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 99188 refers to the application of topical fluoride varnish by a physician or other qualified health care professional. Topical fluoride varnish is a dental treatment that consists of a highly concentrated fluoride formulation suspended in a fast-drying resin base. This varnish is specifically designed to be applied to the surfaces of teeth, particularly the flat surfaces and the pits and fissures of molars. Upon application, the fluoride varnish adheres to the tooth surfaces and forms a sticky residue that hardens upon contact with saliva, creating a protective layer. This treatment serves multiple purposes, including acting as a desensitizing agent for sensitive teeth and playing a crucial role in the prevention and potential reversal of dental caries (tooth decay). The application of fluoride varnish is not limited to dental professionals; it can also be performed by other trained health care providers, such as physicians, nurses, and medical or dental assistants. Prior to the application of fluoride varnish, it is essential for the patient to undergo an oral examination and a risk-based assessment to determine their susceptibility to dental caries. The varnish is applied only to patients identified as being at medium to high risk for developing cavities. The procedure involves cleaning and drying the teeth before the varnish is carefully painted onto the tooth surfaces using a small brush or applicator. After the application, patients are advised to avoid eating or drinking for at least 30 minutes and to refrain from brushing their teeth for a period of 12 hours to ensure optimal effectiveness of the treatment.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The application of topical fluoride varnish is indicated for patients who are at medium to high risk for dental caries. This procedure is particularly beneficial for individuals who may have a history of tooth decay, poor oral hygiene, or other factors that increase their susceptibility to cavities. The use of fluoride varnish is also indicated for patients experiencing tooth sensitivity, as it can serve as a desensitizing agent. Prior to the application, a thorough oral examination and risk-based assessment should be conducted to determine the appropriateness of this treatment.

  • Medium to High Risk for Dental Caries Patients identified as having a higher likelihood of developing cavities due to various risk factors.
  • Tooth Sensitivity Individuals experiencing discomfort or sensitivity in their teeth may benefit from the desensitizing properties of fluoride varnish.

2. Procedure

The procedure for applying topical fluoride varnish involves several key steps to ensure effective treatment. First, the patient's teeth must be thoroughly cleaned and dried to remove any plaque or debris that could interfere with the adhesion of the varnish. This step is crucial as it prepares the tooth surfaces for optimal application. Next, the fluoride varnish is carefully applied to the teeth using a small brush or applicator. The application should cover all relevant surfaces, including the flat areas and the pits and fissures of molars, to maximize the protective benefits of the varnish. Once the varnish is applied, it forms a sticky residue that hardens upon contact with saliva, creating a protective barrier on the teeth. After the procedure, patients are instructed to refrain from eating or drinking for at least 30 minutes to allow the varnish to set properly. Additionally, they should avoid brushing their teeth for a period of 12 hours following the application to ensure that the fluoride has adequate time to penetrate the enamel and provide its protective effects.

  • Step 1: Oral Examination and Risk Assessment Conduct a thorough oral examination and risk-based assessment to determine the patient's eligibility for fluoride varnish application.
  • Step 2: Cleaning and Drying Clean and dry the teeth to ensure that the varnish adheres effectively to the tooth surfaces.
  • Step 3: Application of Varnish Apply the fluoride varnish to the tooth surfaces using a small brush or applicator, ensuring complete coverage of the relevant areas.
  • Step 4: Post-Application Instructions Instruct the patient to avoid eating or drinking for 30 minutes and refrain from brushing for 12 hours to allow the varnish to set and provide maximum benefit.

3. Post-Procedure

After the application of topical fluoride varnish, patients should follow specific post-procedure care instructions to ensure the effectiveness of the treatment. It is essential for patients to avoid eating or drinking for at least 30 minutes, as this allows the varnish to adhere properly to the tooth surfaces and maximize its protective effects. Additionally, patients are advised not to brush their teeth for a minimum of 12 hours following the application. This precaution helps to maintain the varnish on the teeth, allowing the fluoride to penetrate the enamel and provide its intended benefits. Patients should also be informed about the importance of maintaining good oral hygiene practices and regular dental check-ups to monitor their dental health and the effectiveness of the fluoride treatment.

Short Descr APP TOPICAL FLUORIDE VARNISH
Medium Descr APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP
Long Descr Application of topical fluoride varnish by a physician or other qualified health care professional
Status Code Non-Covered Service
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Non-Covered Service, not paid under OPPS
Type of Service (TOS) 1 - Medical Care
Berenson-Eggers TOS (BETOS) M5D - Specialist - other
MUE 1
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
Date
Action
Notes
2015-01-01 Added Added
Code
Description