The short version
# D1351 Dental Code: Sealant per Tooth
D1351 reports placement of a sealant on one tooth. The claim quantity must match the treated tooth numbers, while the chart records the pits, fissures, condition, material, and retention check. A plan may narrow coverage to permanent molars without occlusal decay or restorations even when the dentist's clinical use is broader.
- Bill D1351 once for each tooth that receives a sealant.
- Document the treated surface condition. Sealants can be clinically used on sound pits and fissures or noncavitated lesions under the ADA-AAPD guideline.
- One public Delta plan covers D1351 once per permanent molar every 36 months per provider when the occlusal surface has no decay or restoration.
- That same plan includes repair or replacement within 36 months in the original provider's fee.
- D1352 was deleted for CDT 2026. A one-surface posterior resin restoration is now reported with D2391 when that restorative procedure is performed.
- In a four-molar example, $260 in charges becomes a $160 allowable. The plan pays $160, the patient owes $0, and the office adjusts $100.
What is D1351?
D1351 is a per-tooth preventive sealant procedure. Sealant material is placed into susceptible pits and fissures to isolate the surface. The joint ADA-AAPD guideline supports sealants on occlusal surfaces of primary and permanent molars that are sound or have noncavitated lesions in children and adolescents.
| Fact | D1351 |
|---|---|
| CDT category | Other preventive services |
| Unit | Per tooth |
| Target anatomy | Pits and fissures on selected teeth |
| Clinical condition in guideline | Sound surface or noncavitated lesion |
| Public fee references | Oregon Medicaid: $41.65; Georgia Medicaid: $31.05 in 2025 material |
When do you bill D1351?
Use D1351 when the dentist selects a susceptible surface and the office places a sealant.
- Record the patient's caries risk and tooth number.
- Describe the treated pits or fissures and their preoperative condition.
- Note cleaning, isolation, preparation, material, and cure.
- Verify coverage and retention before ending the appointment.
- Check prior D1351 and D1353 history by tooth.
D1351 vs D2391 and D1354
Surface condition and treatment purpose decide the code.
| D1351 | D2391 | D1354 | |
|---|---|---|---|
| Procedure | Sealant placement | One-surface posterior resin restoration | Caries-arresting medicament |
| Unit | Per tooth | Per tooth | Per tooth |
| Tooth preparation | Sealant technique | Restorative preparation as needed | No mechanical removal of sound tooth structure |
| Main record | Surface eligibility and material | Restored surface and material | Active lesion, product, and arresting intent |
What does insurance actually do with D1351?
A published Delta California rule limits D1351 to one placement per permanent molar per provider every 36 months if the occlusal surface has no decay or restoration. It includes D1353 repair or D1351 replacement within that period in the original provider's fee.
- Four teeth at $65 each: $260
- Four contracted allowances at $40 each: $160
- Contractual adjustment: $100
- Plan payment at 100%: $160
- Patient balance: $0
Why does D1351 get denied?
- The tooth history doesn't clear the sealant frequency.
- The tooth isn't in the plan's eligible tooth group.
- The surface doesn't meet the payer's condition rule.
- The plan doesn't pay a repair separately from the original provider's placement.
What documentation gets D1351 paid?
- Don't omit any treated tooth or surface.
- Don't omit caries risk or the preoperative surface condition.
- Don't leave the sealant material or placement steps unnamed.
- Don't skip prior D1351 and D1353 dates by tooth and provider.
- Don't estimate benefits without the payer's age, tooth, and replacement limits.
Common questions about D1351
Is D1351 billed per surface?
No. A sealant can cover more than one susceptible surface on the same tooth, but the claim still carries one unit for that tooth. Record the tooth number and every sealed surface in the clinical note and claim for that date.
Can a noncavitated lesion receive a sealant?
The ADA-AAPD guideline supports sealants on noncavitated occlusal lesions in the covered populations. The dentist must determine that the lesion is clinically suitable for a sealant and document the tooth, surface, diagnosis, treatment decision, and service completed for that patient.
What replaced D1352 in 2026?
The ADA says the deleted procedure can be reported with D2391 when the dentist performs a one-surface posterior resin restoration. That doesn't mean every former D1352 situation automatically becomes D2391. Code the work completed, document the surfaces and diagnosis, and use the current CDT manual for the final selection.
Is D1351 the same as D1354?
No. D1351 seals a susceptible pit or fissure. The D1354 guide covers a medicament applied to arrest or inhibit an active cavitated lesion. The tooth condition, treatment goal, and delivered material must support the chosen claim line and clinical note.
Audit the odontogram before filing
Don't file until every unit matches the treated tooth, surface, and history.
Sources
- ADA-AAPD, evidence-based sealant guideline
- AAPD, pit-and-fissure sealants overview
- AAPD, policy on sealant reimbursement
- ADA News, deleted CDT codes for 2026
- ADA News, Code Maintenance Committee 2026 changes
- Delta Dental, California sealant limitations
- Oregon Medicaid, June 2025 fee schedule
- Georgia Medicaid, 2025 dental manual and fee material
CDT codes and nomenclature are copyright © American Dental Association. This guide explains the code in plain language; the current CDT manual is the authoritative source.
