Contact DentaQuest Member Services. Find the specific content you are looking for from our extensive Provider Manual. These changes, described below and in this document, will take effect on November 12, 2018. The plan further determined to deny the Appellants dentists prior approval request for a crown (D2751) on the same teeth on the ground that the root canal treatment was not approved. The rules and limitations for different dental services are included in the policy manual. Medicaid Managed Care has a year-round open enrollment period. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful. * *The fee schedule amount for "orthodontic exam and evaluation" codes D8660, D0340,D0330 . Get inspired on our Blog, find answers to your questions in our FAQs, and explore our health library. Learn more about Monkeypox, including prevention and treatment,here. Monkeypox cases are rising in NYC. %PDF-1.4 % If there are no similar listed dental codes, the provider should use CDT code 09999 "Unlisted Adjunctive Procedure By Report", where the provider should establish a fee consistent in relativity with the other fees listed in the dental fee schedule. Submit Electronic Claims and Dental Claim Forms. Nofault cases are subject to different policy interpretations. 18 NYCRR 513.0, provides that prior approval of medical, dental and remedial care, services or supplies is required under the MA program, such prior approval will be granted when the medical, dental and remedial care, services or supplies are shown to be medically necessary to prevent, diagnose, correct or cure a condition of the recipient. We offer five dental plans to employer groups throughout New York State and to their employees who live in or out of the state.
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