CSHCN 2008 > Dental > Benefits and Limitations

   
 

13.3.6.2 Cleft/Craniofacial Surgery

The following surgery codes are payable to a dentist physician only if the dentist physician also is enrolled as a member of or affiliated with a cleft/craniofacial team.

Refer to: Section 3.1.8.2, "Requirements for Cleft/Craniofacial (C/C) Center Team Enrollment," on page 3-4, Section 13.3.6.2, "Cleft/Craniofacial Surgery," on page 13-32, and Section 24.1.3, "Specialty Team/Center," on page 24-4 for more information.

All of the following cleft/craniofacial surgery procedures must be prior authorized:

Procedure Codes

2-21079

2-21080

2-21081

2-21082

2-21083

2-21084

2-21085

2-21086

2-21087

2-21088

2-21089

2-21100

2-21110

2/8-21120

2/8-21121

2/8-21122

2/8-21123

2/8-21125

2/8-21127

2/8-21137

2/8-21138

2/8-21139

2/8-21141

2/8-21142

2/8-21143

2/8-21145

2/8-21146

2/8-21147

2/8-21150

2/8-21151

2/8-21154

2/8-21155

2/8-21159

2/8-21160

2/8-21172

2/8-21175

2/8-21179

2/8-21180

2/8-21181

2/8-21182

2/8-21183

2/8-21184

2/8-21188

2/8-21193

2/8-21194

2/8-21195

2/8-21196

2/8-21198

2/8-21199

2/8-21206

2/21208

2/8-21209

2/8-21210

2-21215

2/8-21230

2/21235

2/8-21244

2-21245

2-21246

2/8-21247

2-21248

2-21249

2/8-21255

2/8-21256

2/8-21260

2/8-21261

2/8-21263

2/8-21267

2/8-21268

2-21270

2-21275

2-21280

2-21282

2-21295

2-21296

2/8-21299

2-30460

2-30462

2-30520

2-40650

2-40652

2-40654

2-40700

2-40701

2-40702

2-40720

2-42200

2-42205

2/8-42210

2-42215

2-42220

2-42225

2-42226

2-42227

2-42235

2-42260


Texas Medicaid & Healthcare Partnership
CPT only copyright 2007 American Medical Association. All rights reserved.
PreviousNextIndex