Policy No: 39
Originally Created: 01/01/2011
Last Reviewed: 01/01/2019
Last Revised: 01/01/2018
Surgical placement of implant body: endosteal implant (D6010)
Surgical placement of mini implant (D6013)
Procedure is in accordance with generally accepted standards of dental practice.
Placement of mini implants are not a benefit of the dental contract.
Prefabricated or custom fabricated abutments are not a covered benefit if the implant is not covered. Crowns supported by an implant are a covered benefit regardless whether or not the implant was covered.
There are no additional benefits for supplemental procedures such as bone grafts, tissue grafts or membranes or sinus lift procedures.
Process to contract benefits.
CDT - D5000-D6999 - see above
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