Policy No: 67
Originally Created: 09/01/1997
Last Reviewed: 01/01/2019
Last Revised: 01/01/2018
The use of special techniques to correct the anterior tongue position, also called tongue thrust, and its associated problems (i.e., open bite, protrusion of incisors and lisping).
Procedure is in accordance with generally accepted standards of dental practice.
Process to contract benefits.
- Appliances for habit breaking of tongue thrust - Process to the orthodontia benefit. Procedure codes D8210 & D8220
- Appliances for speech therapy as a result of tongue thrust - Process to the medical benefit CPT code 21084
CDT - see above
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