 |
|
|
 |
 |
|
|
|
Clinical Coverage Policies and Manuals
Proposed Medicaid Clinical Coverage Policies
Reporting a Change in Provider Status
DMA Clinical Policy and Programs
Mark W. Casey, DDS, MPH
Dental Director
Phone: 919-855-4280
Fax: 919-715-2738
Dental services are defined as diagnostic, preventive or corrective procedures provided by or under the supervision of a dentist. This includes services to treat disease, maintain oral health, and treat injuries or impairments that may affect a recipient’s oral or general health. Orthodontics is defined as a corrective procedure for functionally handicapping conditions.
All services must maintain a high standard of quality and must be provided within the reasonable limits of those that are customarily available and provided to most persons in the community in accordance to Medicaid’s policies and procedures.
Medicaid has adopted procedure codes and descriptions as defined in the most recent edition of Current Dental Terminology (CDT-2009-2010). CDT-2009-2010 (including procedure codes, descriptions, and other data) is copyrighted by the American Dental Association.
For service requirements, coverage criteria and limitations, refer to:
Information about budget initiatives affecting dental services is available on the Budget Initiatives web page.
For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.
To see forms that apply to all providers, please visit our Provider Forms page.
