Treatment for Teeth Malalignment or Malocclusion

Policy No: 54
Originally Created: 03/01/1997
Section: Orthodontics
Last Reviewed: 01/01/2019
Last Revised: 01/01/2018
Approved: 01/01/2018
Effective: 01/01/2018

Description

Orthodontia (D8010 - D8999)

  • The interception and treatment of malocclusion of the teeth and their surrounding structures.
  • Limited orthodontic treatment of the primary dentition (D8010)
  • Limited orthodontic treatment of the transitional dentition (D8020)
  • Limited orthodontic treatment of the adolescent dentition (D8030
  • Limited orthodontic treatment of the adult dentition (D8040)
  • Interceptive orthodontic treatment of the primary dentition (D8050)
  • Interceptive orthodontic treatment of the transitional dentition (D8060)
  • Comprehensive orthodontic treatment of the transitional dentition (D8070)
  • Comprehensive orthodontic treatment of the adolescent dentition (D8080)
  • Comprehensive orthodontic treatment of the adult dentition (D8090)

Removable appliance therapy (D8210)

  • Removable indicates patient can remove; includes appliances for thumb sucking and tongue thrusting.

Fixed appliance therapy (D8220)

Fixed includes patient cannot remove appliance; includes appliances for thumb sucking and tongue thrusting.

Policy/criteria

Procedure is in accordance with generally accepted standards of dental practice.

Administrative guidelines

Process to contract benefits.

  • Panoramic films billed for orthodontia -- Process to orthodontia benefit.
  • Panoramic films billed for orthodontia, with no orthodontia benefit -- Process to preventive benefit.

Codes

CDT - D8000-D8999 - see above

Disclaimer

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