There are different groups of dental treatments and each group has its own acts with corresponding codes and tariffs.
Consultations and visits
Consultations with a dentist appear on the invoice with the codes DC1 to DC8 of the dentists' nomenclature. The code differs whether it is a normal consultation, an urgent consultation or a consultation taking place in the evening or on a public holiday.
Visits from a dentist can take place either outside or inside of a hospital. Visits at home (out of the hospital setting) generally appear on the invoice with the codes DV1 to DV8, whether it is a normal, urgent or out of the regular schedule visit. Visits from a dentist outside of the hospital are invoiced with the codes DV11 to DV18.
(Daily) Flat rates for stationary hospital treatments provided by dentists are invoiced using the codes DF10 to DF13 and DF20 to DF23. The used code depends on the hospitalisation day of the patient.
The removal of plaque (DS1) is only covered once every 6 months.
Gingival and dental care
On the invoice, treatments from this category carry the codes DS1 to DS36. They are for example removal of plaque (DS1), dental fillings (DS14 to DS16), dental reconstructions (DS18 to DS19) or local (DS20) or regional anaesthetics (DS21).
The nomenclature distinguishes between dental extractions (DS61 to DS79M) and surgical extractions (DS88 to DS96).
Regional or local anaesthetics
The health insurance covers local (DS20) or regional (DS21) anaesthetics provided under the codes DS20 and DS21 of the dentists' nomenclature of acts and services or under suffix "L" referred to in article 12 of the general section of the dentists' nomenclature only in the following situations:
- In case of fillings (DS14, DS15, DS16 and DS19), extractions, pulpectomies (DS10, DS11 et DS12) or dental treatments provided for in chapter 9 of the second section of the doctors' nomenclature in the lower maxilla, the health insurance only covers one regional anaesthetic per session and per hemi-maxilla.
- For the upper maxilla, the health insurance only covers one local anaesthetic per session and
- per tooth to be extracted
- per tooth to be devitalised (DS10, DS11 and DS12)
- per tooth to be filled (DS14, DS15, DS16 and DS19) as well as
- per hemi-maxilla for dental treatments provided for in chapter 9 of the second section of the doctors' nomenclature and performed under local anaesthetic.
Unless performed by on-call staff or in a situation of recognised emergency, or in the case of an extraction of more than three teeth, hospital stays and treatments related to arcades dental surgery and gingival surgery, gingival and dental care or dental and surgical extractions cannot be claimed from the health insurance without the previous assent of the medical board under one of the following conditions:
- when the patient is allergic to local anaesthetics;
- when given the need for immediate action to deal with an acute inflammation, satisfactory analgesia cannot be obtained by a local anaesthetic;
- in the case of dental treatment of mentally and physically handicapped people and invalids for whom a local anaesthetic is not feasible, owing to the patient's condition;
- in case of the extraction of an impacted or embedded wisdom tooth for which satisfactory analgesia cannot be obtained by a local anaesthetic, with the diagnosis to this effect supported by radiographic evidence.