TAR and Non-Benefit List: Codes 40000 thru 49999 (tar and ...
40819 Excision of frenum, labial or buccal Assistant Surgeon services not payable 40820 Destruction of lesion/scar by physical methods Assistant Surgeon services not payable Repair Code Description Benefit Restrictions 40830 Closure of laceration, vestibule of mouth, 2.5 cm or less Assistant Surgeon services not payable Other Procedures ................
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