Adjunctive General Services Section - Other
Drugs and/or Medicaments
| Topic: Other Drugs and/or Medicaments |
Last Reviewed Date: 01/2003 |
| Section: Adjunctive General Services |
Policy No: 57A |
| Revised/Effective Date: 01/2003
|
Next Review Date: 01/2005 |
IMPORTANT INFORMATION
This Dental Policy has been developed through consideration of
generally accepted standards of dental practice, review of dental literature,
dental necessity, and as appropriate, government approval.
Benefit determinations should be based
in all cases on the applicable contract language.
To the extent there are any conflicts between these guidelines and the
contract language, the contract language will control.
The purpose of dental policy is to provide a guide to coverage. Dental
policy is not intended to dictate to providers how to practice dentistry.
Providers are expected to exercise their clinical judgment in providing
the most appropriate care.
|
Description
Other drugs and/or medicaments, by report (D9630):
Includes, but is not limited to, oral antibiotics,
oral analgesics, oral sedatives, and topical fluoride
dispensed in the office for home use; does not include
writing prescriptions.
Policy/Criteria
Procedure is in accordance with generally accepted standards
of dental practice.
Administrative Guidelines
Process to contract benefits.
| Codes |
Number |
Description |
| CDT |
D9000-D9999 |
See above |
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