No. We advise you send us a duplicate or copies of current/dated images that are of diagnostic quality. All images must be of diagnostic quality, labeled including L or R as applicable and contain appropriate landmarks views.
Payor identification numbers are specific to the clearing house you use. Please contact your clearing house with questions regarding payor identification numbers. The most commonly used payor ID codes are as follows:
Yes. Composite resin fillings are a covered benefit on all teeth; however, alternate benefit provisions may apply. Check the Claim Processing Guidelines for tooth numbers where alternate benefit provisions may apply.
Since each patient’s periodontal condition is unique, there is a reasonable period required to allow for re-evaluation following periodontal therapy – generally, 4-6 weeks before initiating maintenance treatment.
The D4381 is not generally a covered benefit except in well documented refractory cases where an isolated tooth or limited teeth are involved. Re-evaluation following periodontal therapy must be well documented. (A period of at least 4-6 weeks elapsed following active periodontal therapy.)
Scaling in the Presence of Generalized Inflammation is covered, subject to contract limitations, and should not be reported in conjunction with routine cleanings, scaling and root planning, or full mouth debridement.
Use the Procedure Code Lookup field and search for a code associated with a crown. Crown, bridge, and other prosthodontic procedures may be subject to Alternate Benefit Plan provisions. Also, procedures may be subject to Professional Review.
If preventive or diagnostic procedures for orthodontic records are performed on an eligible patient, then these services are processed under the orthodontia benefit. They do not count against the preventive frequencies.
Do-It-Yourself (DIY) orthodontic treatments are not a covered benefit. Our dental benefit plans only cover orthodontic treatment that is provided, supervised and completed by a licensed dental professional.