Prosthodontic Services. All dentures, fixed prosthodontics (fixed bridges) and maxillofacial prosthetics require prior authorization. New dentures or replacement dentures may be considered every 7 ½ years unless dentures become obsolete due to additional extractions or are damaged beyond repair. All needed dental treatment must be completed prior to denture fabrication. Patient identification must be placed in dentures in accordance with State Board regulation. Insertion of dentures includes adjustments for 6 months post insertion. Prefabricated dentures or transitional dentures that are temporary in nature are not covered. Prosthodontic services to include: Complete dentures and immediate complete dentures – maxillary and mandibular to address masticatory deficiencies. Excludes prefabricated dentures or dentures that are temporary in nature Partial denture – maxillary and mandibular to replace missing anterior tooth/teeth (central incisor(s), lateral incisor(s) and cuspid(s)) and posterior teeth where masticatory deficiencies exist due to fewer than eight posterior teeth (natural or prosthetic) resulting in balanced occlusion. Resin base and cast frame dentures including any conventional clasps, rests and teeth Flexible base denture including any clasps, rests and teeth Removable unilateral partial dentures or dentures without clasps are not considered Overdenture – complete and partial Denture adjustments –6 months after insertion or repair Denture repairs – includes adjustments for first 6 months following service Denture rebase – following 12 months post denture insertion and subject to prior authorization denture rebase is covered and includes adjustments for first 6 months following service Denture relines – following 12 months post denture insertion denture relines are covered once a year without prior authorization and includes adjustments for first 6 months following service Precision attachment, by report Maxillofacial prosthetics - includes adjustments for first 6 months following service Facial moulage, nasal, auricular, orbital, ocular, facial, nasal septal, cranial, speech aid, palatal augmentation, palatal lift prosthesis – initial, interim and replacement Obturator prosthesis: surgical, definitive and modifications Mandibular resection prosthesis with and without guide flange Feeding aid Surgical stents Radiation carrier Fluoride gel carrier Commissure splint Surgical splint Topical medicament carrier Adjustments, modification and repair to a maxillofacial prosthe...
Prosthodontic Services. Repair or rebasing of an existing full or partial denture; Initial installation of fixed bridgework; Implants; Initial installation of partial or full removable dentures (including adjustments for six [6] months following installation); Construction and replacement of dentures and bridges (replacement of existing dentures or bridges is payable when five [5] years or more have elapsed since the date of the initial installation).
Prosthodontic Services. All dentures, fixed prosthodontics (fixed bridges) and maxillofacial prosthetics require prior authorization. New dentures or replacement dentures may be considered every 7 ½ years unless dentures become obsolete due to additional extractions or are damaged beyond repair. All needed dental treatment must be completed prior to denture fabrication. Patient identification must be placed in dentures in accordance with State Board regulation. Insertion of dentures includes adjustments for 6 months post insertion. Prefabricated dentures or transitional dentures that are temporary in nature are not covered. Prosthodontic services to include:
Prosthodontic Services. 13 Repair or rebasing of an existing full or partial denture; 14 Initial installation of fixed bridgework;
Prosthodontic Services. Services and appliances that replace missing natural teeth (such as bridges, endosteal implants, partial dentures, and complete dentures).
Prosthodontic Services. Procedures for construction of fixed bridges, partial dentures, complete dentures, and/or adjustment or repair of an existing prosthodontic device.
Prosthodontic Services a) Removable
Prosthodontic Services. To include bridges, partials and complete dentures.
Prosthodontic Services. A. DENTURES - Construction and insertion of dentures. Limited until after the person has been insured continuously under this benefit for a period of 12 consecutive months, unless a tooth is extracted.
Prosthodontic Services a) Crowns (refer to Xxxxxxx 0x Xxxxxxxxxxx, Xxxxxx);
