CSHCN 2009 > Dental > Benefits and Limitations

   
 

14.2.5.18 Noncovered Services

The following therapeutic services are not considered to be medically necessary; therefore, they are not a benefit of the CSHCN Services Program.

Procedure Codes

D3331

D3332

D3333

D6058

D6059

D6060

D6061

D6062

D6063

D6064

D6065

D6066

D6067

D6068

D6069

D6070

D6071

D6072

D6073

D6074

D6075

D6076

D6077

D6078

D6079

D6094

D7412

D7671

D7771

D7830

D9972

D9973


Texas Medicaid & Healthcare Partnership
CPT only copyright 2008 American Medical Association. All rights reserved.
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