Replacement of Lost or Broken Retainer

Policy No: 54B
Originally Created: 01/01/2001
Section: Orthodontics
Last Reviewed: 01/01/2019
Last Revised: 01/01/2018
Approved: 01/01/2018
Effective: 01/01/2018

Description

Replacement of lost or broken retainer (D8692)

Policy/criteria

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

Administrative guidelines

Process to orthodontic benefit.

Not a covered benefit if there is a contract exclusion for lost or stolen appliances.

Codes

CDT - D8000-D8999 - see above

Disclaimer

Your use of this Dental Policy constitutes your agreement to be bound by and comply with the terms and conditions of the Dental Policy Disclaimer.