Medically Necessary Braces

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Medically Necessary Braces

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Billing Guide – Washington State Health Care Authority

Oct 1, 2015 There is a new version of HCA 13-. 666. It will be the only version accepted as of
January1, 2016. Medical justification. Language updated to match forms ….
Interceptive orthodontics for severe malocclusion . ….. The agency covers
medically necessary orthodontic treatment and orthodontic-related services.

ORTHODONTIC SERVICES Provider Guide – Washington State …

Jul 1, 2014 Interceptive orthodontics for cleft palate . ….. The agency covers medically
necessary orthodontic treatment and orthodontic-related services … requirements
and limitation list within this provider guide, for clients with one of the following
medical conditions: •. Cleft lip and palate, cleft palate, or cleft lip with …

Orthodontic Services – Alaska Department of Health and Social …

Jul 1, 2015 specific requirements of 7 AAC 110.153 and general program requirements of 7
AAC 105 – 7. AAC 160. … Other pertinent medical or dental information to
support the requested orthodontic treatment … than eighteen (18) months have
elapsed between the last treatment of limited orthodontics and the.

10. Dental Services All dental services performed must be medically

All dental services performed must be medically necessary and may not be
experimental in nature. Medical necessity is determined by generally accepted
North Carolina community practice standards as verified by independent
Medicaid consultants. a. Routine dental examinations and screening tests are
covered for …

Medically Necessary Orthodontia Unit – Arizona Department of Child …

and dental care for children in care, including medically necessary dental and
orthodontic services … those medical and dental services which are necessary to
the achievement and maintenance of an optimal level of physical … that should
be avoided while he/she is in braces (e.g. nuts, sticky candy, popcorn, pretzels,

Orthodontic Medical Necessity (OMN) Form – Nevada Medicaid

Jun 29, 2017 the medical appropriateness of an orthodontic treatment plan as opposed to
other available dental treatment. Review MSM Chapter 1000 – Dental for
complete coverage and limitations policy for Orthodontics. Medically Necessary
Orthodontics are deemed necessary and qualified when it is part of a case …

Dental Provider Manual – New Hampshire Department of Health and …

Mar 13, 2013 coverage for medically necessary EPSDT services, including comprehensive
dental services. The NH Medicaid … NH Medicaid does not cover treatment that
is not medically necessary, that is cosmetic in nature, is experimental or …
Special Eligibility for Comprehensive Orthodontics. Although patients must …

Member Handbook – DMAS – Commonwealth of Virginia

Services for Children. Smiles For Children members are covered for all medically
necessary dental services, as well as orthodontic. (braces) procedures provided
by a participating dentist. Dental services include relief of pain and infection,
restoration of teeth, and maintenance of dental health. An oral screening may be

medicaid services chart – Louisiana Department of Health

lip, or other medical conditions which possibly results in a handicapping
malocclusion. If such a condition exists, the recipient should see a Medicaid-
enrolled orthodontist. Patients having only crowded or crooked teeth, spacing
problems or under/overbite are not covered for braces, unless identified as
medically necessary.

Dental Fee Schedule – Pennsylvania Department of Human Services

who require medically necessary dental services beyond the fee schedule limits,
the dentist should request a waiver of the limits, as applicable, through the 1150
…. Prior authorization is required for orthodontics, complete and partial dentures,
crowns, surgical extraction(s) of impacted tooth/teeth, crowns and periodontal …

NC Division of Medical Assistance Medicaid and … – Amazon AWS

Oct 1, 2015 Orthodontics is defined as a corrective procedure for functionally impairing
occlusal conditions. … Medically necessary services will be provided in the most
economic mode, as long as the …. If a non-covered orthodontic service is
deemed medically necessary and warrants consideration of approval, the …

Commonwealth of Kentucky – Kentucky: Cabinet for Health and …

If You Are a Managed Care Organization (MCO) Members. An MCO is a group of
doctors, pharmacies and other medical providers you use for your medical care.
Your MCO pays your provider for Medicaid covered services. You must use
providers who are contracted with your MCO or you may have to pay for the
services …

Handicapping Labio-Lingual Deviations Form –

Jul 1, 2016 Providers may submit a medical necessity narrative (along with the required
completed HLD) in any case where, in the professional judgment of the
requesting provider and any other involved clinician(s), comprehensive
orthodontic treatment is medically necessary to treat a handicapping

Deny coverage for comprehensive orthodontic treatment for the …

Redacted, mother and representative of minor Appellant Redacted, appeals the
decision of the Division of and Medical Assistance (DMMA) to deny coverage for
comprehensive orthodontic treatment for the minor Appellant to acquire braces.
DMMA claims that the. Appellant's case does not meet Medicaid requirements for

Understanding orthodontic benefits for Delta Dental PPOSM and …

Orthodontics is a dental specialty dedicated to diagnosing, preventing and
treating malocclusion (improper … the use of active orthodontic appliances (such
as braces) and post-treatment retentive appliances (such as retainers). … the
required claim form (available from our web site) directly to us for reimbursement
of …

GEHA Connection Dental Federal 2014 – OPM

*D6100 Implant removal, by report. The orthodontics age limitation has been
removed under Class D Orthodontic Services. Orthodontic treatment is covered
only when medically necessary to treat a malocclusion that causes a functional
disability. Treatment done to improve facial esthetics is considered cosmetic and
is not …

Idaho Health Plan Coverage – Idaho Department of Health and …

oral surgery, orthodontics when necessary, emergency dental care, and other
medically necessary treatment. – Adults on a Medicaid Enhanced plan, adults
age 21 and older, including those who are receiving Aged and Disabled or
Developmental Disabilities waiver services can get dental services including
exams, fillings …

medicaid policy bulletin – State of Michigan

Oct 1, 2005 the medical criteria and qualifying diagnoses for specialty dental services, such
as orthodontics, can be found in the CSHCS chapter of the Medicaid manual … A
prior authorization request is necessary for each stage of orthodontic treatment,
such as interceptive or comprehensive treatment. For all requests …