CSHCN 2008 > Dental > Benefits and Limitations

   
 

13.3.4.8 Implants

Implants require prior authorization.

To obtain prior authorization, the following must be submitted:

The CSHCN Services Program Prior Authorization Request for Dental or Orthodontia Services form.

Documentation of medical necessity for the requested procedure.

Use the following procedure codes for implant services:

Procedure Codes
Limitations

D6010

A = 16 years of age and older, prior authorization

D6040

A = 16 years of age and older, prior authorization

D6050

A = 16 years of age and older, prior authorization

D6055

A = 16 years of age and older, prior authorization

D6056

A = 16 years of age and older, prior authorization

D6057

A = 16 years of age and older, prior authorization

D6080

A = 16 years of age and older, prior authorization

D6090

A = 16 years of age and older, prior authorization

D6095

A = 16 years of age and older, prior authorization

D6100

A = 16 years of age and older, prior authorization

D6199

A = 16 years of age and older, prior authorization

A = Age limitation

The following procedure codes are not considered medically necessary:

Procedure Codes

D6058

D6059

D6060

D6061

D6062

D6063

D6064

D6065

D6066

D6067

D6068

D6069

D6070

D6071

D6072

D6073

D6074

D6075

D6076

D6077

D6078

D6079

D6094

D6194


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CPT only copyright 2007 American Medical Association. All rights reserved.
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