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November 13, 2017
State of Alabama
Press Release: Medicaid
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PDF Version
TO: All Dental Providers, Oral Surgeons, Federally Qualified Health Centers (FQHC), Rural Health Centers (RHC) and State Agencies
Procedure codes
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Description
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Change
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D0230, D0240, D0272, D0274
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X-ray/radiographs
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D0230 is limited
to two per year when used in combination with D0272 and D0274. D0240 is
limited to two per calendar year. D0272 and D0274 are limited to one per
calendar year.
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D3230, D3240
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Pulpal therapy
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Reduction of
reimbursement to $131 for D3230 and $157 for D3240
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D2140, D2150, D2160,
D2161, D2330, D2331, D2332, D2335, D2391, D2392, D2393, D2394, D7140, D2930,
D2931, D2932
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Restoration of
same surface
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No reimbursement
for a restoration that involves a surface previously restored on the same
tooth within the preceding 12 months. (example: If an occlusal restoration is
placed on a tooth, no other restoration involving the occlusal surface would
be reimbursable if placed within the following 12 months).
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D2140, D2150, D2160,
D2161, D2330, D2331, D2332, D2335, D2391, D2392, D2393, D2394, D7140, D2740,
D2750, D2751, D2752, D2791, D2792, D2930, D2931, D2932, D2940, D2950, D2951,
D2952, D2953, D2954, D2957
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Restoration of same tooth
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No reimbursement for any restoration on the same tooth if
treated within the previous 6 months. (example: If an occlusal restoration is
placed on a tooth, then a buccal restoration is placed at a later date. This
would be reimbursed if they are at least 6 months apart, but not if less than
six months.)
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D9230
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Use of nitrous oxide
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Reduction of reimbursement for use of nitrous oxide to $20 per
unit
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As a reminder, the Provider Billing Manual is updated each quarter (January, April, July, and October) and these changes will be reflected in Chapter 13 of the January 2018 Provider Billing Manual.
Please also refer to Chapter 1-6 of the Provider Billing regarding general information for providers.
You may contact the Dental program for questions by emailing elizabeth.huckabee@medicaid.alabama.gov.
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2017 American Medical
Association and © 2017 American Dental Association (or such other date publication of CPT
and CDT). All rights reserved. Applicable FARS/DFARS apply.
For more information, visit http://medicaid.alabama.gov
For more state-wide press releases, click here
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