Important News for Medicaid Providers

by on July 25, 2011

Attn: Dental Providers

Subject: Dental Service Prior Authorization Requirement Changes

Effective July 18, 2011 the following Medicaid Dental Services will no longer require prior authorization:

Oral Exams (all beneficiaries)

D0140Endodontic (Root Canal) Therapy (age 20 and under)




Surgical Extractions (age 20 and under)





Anesthesia (age 20 and under)

D9220 (no PA required when billed with D7210,D7220,D7230,D7240)

D9221 (no PA required when billed with D7210,D7220,D7230,D7240)

Diagnostic Casts (Full Denture) (age 21 and over)

D0470 (refer to section 223.000 for Dental Lab request update)

All prior authorization requests and dental x-rays for these services filed prior to the effective date will be returned to the performing provider in the order received.

Refer to sections 221.000, 225.200, 262.100, 262.200 in the dental provider manual for applicable updates.

(Information provided by Chawnte Booker, Dental Unit Program Coordinator Division of Medical Services, Provider and Member Relations, Dental and Vision Unit: 501-683-0941)

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