Code 99188 is the correct code for application of topical fluoride varnish to prevent dental caries.
Current Procedural Terminology (CPT®) does not limit this code to services provided to certain age groups or limit the frequency of reporting this service. However, many public and private payers have specific coverage policies for application of fluoride varnish. Some payment policies do include age restrictions and those vary significantly (eg, from first tooth eruption to 4 years old, from first eruption through 21 years old). Likewise, the frequency of coverage for fluoride varnish application may be included in payment policies (eg, 4 times per year). Practice managers should investigate the payment policies of payers commonly billed by the practice to determine how to best provide this service to patients in a manner aligned with the practice’s patient care and financial goals.
Also, pediatricians may need to provide a payer with...